Active NPI
Lawrence S Dababneh, LLMSW
- Case Manager/Care Coordinator
- Detroit, MI
National Provider Identifier
1154718534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 62 W 7 Mile Rd
Detroit, MI 48203-1967 - Phone
- (313) 893-6172
- Fax
- (313) 893-0064
- NPI assigned
- Apr 23, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801107453 | MI | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
62 W 7 Mile Rd
Detroit, MI 48203-1967
Mailing address
62 W 7 Mile Rd
Detroit, MI 48203-1967
Phone (313) 893-6172
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3434247 | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801107453 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1154718534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 W 7 MILE RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482031967",
"telephone_number": "313-893-6172",
"fax_number": "313-893-0064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 W 7 MILE RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482031967",
"telephone_number": "313-893-6172",
"fax_number": "313-893-0064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DABABNEH",
"first_name": "LAWRENCE",
"middle_name": "S",
"credential": "LLMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-23",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801107453",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3434247",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}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 Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.