Active NPI
Melissa Raen'E Gibbons, LLMSW
- Social Worker
- Livonia, MI
National Provider Identifier
1205308632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801102550
- Practice address
- 14100 Newburgh Rd
Livonia, MI 48154-5010 - Phone
- (734) 464-7810
- NPI assigned
- Dec 25, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801102550 | MI | Primary |
Addresses
Primary practice location
14100 Newburgh Rd
Livonia, MI 48154-5010
Mailing address
14100 Newburgh Rd
Livonia, MI 48154-5010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6801102550 | Other | MI | DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS - MASTER LTD SOCIAL WORKER |
Other names 1
- Melissa Raen'E Morgan
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 |
|---|---|---|---|
| 6801102550 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545696000000",
"number": "1205308632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14100 NEWBURGH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481545010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14100 NEWBURGH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481545010",
"telephone_number": "734-464-7810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "MELISSA",
"middle_name": "RAEN'E",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-25",
"last_updated": "2018-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801102550",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS - MASTER LTD SOCIAL WORKER",
"identifier": "6801102550",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "MORGAN",
"middle_name": "RAEN'E",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.