Individual provider Active NPI

Eugenija Ann Rukstele, MSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1154657864
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801004836 Issued in MI
Practice address
6001 W Outer Dr
Suite 114
Detroit, MI 48235-2614
Phone
(313) 966-9094
Fax
(313) 966-9418
NPI assigned
Oct 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801004836 MI Primary

Addresses

Primary practice location

6001 W Outer Dr
Suite 114
Detroit, MI 48235-2614

Mailing address

6001 W Outer Dr
Suite 114
Detroit, MI 48235-2614
Phone (313) 966-9094

Other names 1

  • Mrs. Eugeniha Ann Ervasti Former name

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

State licenses

LicenseStateTypeSpecialty
6801004836MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1154657864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 W OUTER DR",
            "address_2": "SUITE 114",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352614",
            "telephone_number": "313-966-9094",
            "fax_number": "313-966-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 W OUTER DR",
            "address_2": "SUITE 114",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352614",
            "telephone_number": "313-966-9094",
            "fax_number": "313-966-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUKSTELE",
        "first_name": "EUGENIJA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801004836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUGENIHA",
            "last_name": "ERVASTI",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.