Individual provider Active NPI

Cynthia M Fenton

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1184786493
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801018846 Issued in MI
Practice address
1312 Oakland Dr
Kalamazoo, MI 49008-1205
Phone
(269) 337-3115
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801018846 MI Primary

Addresses

Primary practice location

1312 Oakland Dr
Kalamazoo, MI 49008-1205

Mailing address

10882 South Dr
Plainwell, MI 49080-9038
Phone (269) 664-4897

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

LicenseStateTypeSpecialty
6801018846MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184786493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10882 SOUTH DR",
            "city": "PLAINWELL",
            "state": "MI",
            "postal_code": "490809038",
            "telephone_number": "269-664-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081205",
            "telephone_number": "269-337-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801018846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.