Active NPI
Justin Tate
- Clinical Social Worker
- Lansing, MI
National Provider Identifier
1184903528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801093280
- Practice address
- 2800 W Willow St
Lansing, MI 48917-1833 - Phone
- (517) 323-4734
- NPI assigned
- Aug 16, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 6801093280 | MI | Primary |
Addresses
Primary practice location
2800 W Willow St
Lansing, MI 48917-1833
Mailing address
2523 Eaton Rd
Lansing, MI 48910-2878
Phone (517) 881-7823
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 |
|---|---|---|---|
| 6801093280 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313452800000",
"number": "1184903528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2523 EATON RD",
"city": "LANSING",
"state": "MI",
"postal_code": "489102878",
"telephone_number": "517-881-7823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 W WILLOW ST",
"city": "LANSING",
"state": "MI",
"postal_code": "489171833",
"telephone_number": "517-323-4734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATE",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-16",
"last_updated": "2011-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801093280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.