Active NPI
Leeanna Jean Wolf
- Social Worker
- Wixom, MI
National Provider Identifier
1144688474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 530 Meadows Cir E
Wixom, MI 48393-4012 - Phone
- (901) 356-9490
- NPI assigned
- Feb 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
530 Meadows Cir E
Wixom, MI 48393-4012
Mailing address
530 Meadows Cir E
Wixom, MI 48393-4012
Phone (901) 356-9490
Other practice location 1
35425 W Michigan Ave Ste 1
Wayne, MI 48184-1600
Phone (734) 467-7600
Other practice location 2
8600 Woodward Ave
Detroit, MI 48202-2142
Phone (313) 875-7601
Other practice location 3
2939 Russell St
Detroit, MI 48207-4825
Phone (313) 396-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 381561624 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666828800000",
"number": "1144688474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 MEADOWS CIR E",
"city": "WIXOM",
"state": "MI",
"postal_code": "483934012",
"telephone_number": "901-356-9490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 MEADOWS CIR E",
"city": "WIXOM",
"state": "MI",
"postal_code": "483934012",
"telephone_number": "901-356-9490"
}
],
"practiceLocations": [
{
"address_1": "35425 W Michigan Ave Ste 1",
"address_purpose": "LOCATION",
"city": "Wayne",
"state": "MI",
"postal_code": "481841600",
"country_code": "US",
"telephone_number": "734-467-7600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8600 Woodward Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022142",
"country_code": "US",
"telephone_number": "313-875-7601",
"fax_number": "313-871-1891",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2939 Russell St",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482074825",
"country_code": "US",
"telephone_number": "313-396-5300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLF",
"first_name": "LEEANNA",
"middle_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-01",
"last_updated": "2022-10-27",
"certification_date": "2022-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "381561624",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wixom, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.