Tanyanne Lee Pittman

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801069877 Issued in MI

Practice address

17348 W 12 Mile Rd Ste 106
Southfield, MI 48076-6325

Phone

(888) 492-9386

NPI assigned

Aug 4, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tonya Ann Pittman Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evolutionary Intervention LLC

  • Community/Behavioral Health Agency
  • Southfield, MI
  • NPI 1679846505
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1154095123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760224",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480760224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17348 W 12 MILE RD STE 106",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480766325",
            "telephone_number": "888-492-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "TANYANNE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801069877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "PITTMAN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Fay Piper
• Michael Charles Piper, LMT
• Melissa Pisz
• Sara P Pitchford, QMHP
• Tammy Pitsch
• Tara Pittman, LMSW
• Elisabeth Pixley-Fink, LLMSW
• PJR & Associated Inc
• Natacha Placide
• Gary Michael Plagens, NP

• Clinical Social Worker in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.