Active NPI
Mark Rose, MSW
- Clinical Social Worker
- Flint, MI
National Provider Identifier
1164750568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801059161
- Practice address
- 420 W 5TH Ave
Flint, MI 48503-2445 - Phone
- (810) 424-6081
- NPI assigned
- Nov 23, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801059161 | MI | Primary |
Addresses
Primary practice location
420 W 5TH Ave
Flint, MI 48503-2445
Mailing address
7774 Brass Creek Dr
Dexter, MI 48130-9338
Phone (734) 426-2880
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801059161 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258934400000",
"number": "1164750568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7774 BRASS CREEK DR",
"city": "DEXTER",
"state": "MI",
"postal_code": "481309338",
"telephone_number": "734-426-2880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W 5TH AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485032445",
"telephone_number": "810-424-6081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "MARK",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-23",
"last_updated": "2009-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801059161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.