Individual provider Active NPI

Naomi Baba, LMSW

  • Social Worker
  • Romeo, MI
National Provider Identifier
1174815518
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801091649 Issued in MI
Practice address
1 N Starkweather Aly FL 3
Romeo, MI 48065-4690
Phone
(586) 281-6815
Fax
(586) 281-6816
NPI assigned
May 4, 2011
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801091649 MI Primary

Addresses

Primary practice location

1 N Starkweather Aly FL 3
Romeo, MI 48065-4690

Mailing address

1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111027000572 MI Practitioner - Clinical Social Worker 4082887542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shine Wellness Clinic PLLCGroup PAC ID 3476825043, 3 clinicians

Practice addresses (Care Compare)

1 N Starkweather Aly
Romeo, MI 48065-4690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801091649MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Wellness Clinic, PLLC Social Worker CurrentSince Jun 10, 2017 Accepting new patients

Locations

1 N Starkweather Aly
Fl 3
Romeo, MI 48065
Phone (586) 281-6815

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1174815518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KRAFFT RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593565",
            "telephone_number": "810-985-5125",
            "fax_number": "810-985-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N STARKWEATHER ALY FL 3",
            "city": "ROMEO",
            "state": "MI",
            "postal_code": "480654690",
            "telephone_number": "586-281-6815",
            "fax_number": "586-281-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABA",
        "first_name": "NAOMI",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801091649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeo, MI

Sources for this page

Verify at the official NPI Registry.