Individual provider Active NPI

Robert Simon, LLMSW, CAADC

  • Clinical Social Worker
  • West Bloomfield, MI
National Provider Identifier
1184179244
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851100045 Issued in MI
Practice address
6555 W Maple Rd
West Bloomfield, MI 48322-4926
Phone
(248) 592-2300
Fax
(248) 592-2310
NPI assigned
Aug 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6801100045 MI
Clinical Social Worker 1041C0700X 6851100045 MI Primary

Addresses

Primary practice location

6555 W Maple Rd
West Bloomfield, MI 48322-4926

Mailing address

6555 W Maple Rd
West Bloomfield, MI 48322-4926
Phone (248) 592-2300

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
I20220815001638 MI Practitioner - Clinical Social Worker 7315320900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Family ServiceGroup PAC ID 8729071170, 13 clinicians

Practice addresses (Care Compare)

6555 W Maple Rd
West Bloomfield, MI 48322-4926
Phone (248) 592-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801100045MIMDAddiction (Substance Use Disorder) Counselor
6851100045MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service Clinical CurrentSince Jul 19, 2022 Accepting new patients

Locations

25900 Greenfield Rd
Ste 405
Oak Park, MI 48237
Phone (248) 406-0076

6555 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 592-2300

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.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1184179244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224926",
            "telephone_number": "248-592-2300",
            "fax_number": "248-592-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224926",
            "telephone_number": "248-592-2300",
            "fax_number": "248-592-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LLMSW, CAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801100045",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851100045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.