Individual provider Active NPI

Thomas Krolicki, LMSW, ACSW, CAADC

  • Clinical Social Worker
  • Woodhaven, MI
National Provider Identifier
1164889275
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801067478 Issued in MI
Practice address
23650 Oakleigh Ave
Woodhaven, MI 48183-2783
Phone
(313) 806-4873
NPI assigned
Jan 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 6801067478 MI Primary

Addresses

Primary practice location

23650 Oakleigh Ave
Woodhaven, MI 48183-2783

Mailing address

23650 Oakleigh Ave
Woodhaven, MI 48183-2783
Phone (313) 806-4873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801067478MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1164889275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23650 OAKLEIGH AVE",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481832783",
            "telephone_number": "313-806-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23650 OAKLEIGH AVE",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481832783",
            "telephone_number": "313-806-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLICKI",
        "first_name": "THOMAS",
        "credential": "LMSW, ACSW, CAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-20",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801067478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, MI

Sources for this page

Verify at the official NPI Registry.