Individual provider Active NPI

Destiny Rae Ventimiglia, LMSW

  • Clinical Social Worker
  • Clinton Township, MI
National Provider Identifier
1215502265
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801109737 Issued in MI
Practice address
38800 Garfield Rd Ste 100
Clinton Township, MI 48038-6619
Phone
(586) 231-0306
NPI assigned
May 21, 2021
Last updated
May 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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 6801109737 MI Primary

Addresses

Primary practice location

38800 Garfield Rd Ste 100
Clinton Township, MI 48038-6619

Mailing address

38800 Garfield Rd Ste 100
Clinton Township, MI 48038-6619
Phone (586) 231-0306

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
I20250516000367 MI Practitioner - Clinical Social Worker 5597283267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological Professional ServicesGroup PAC ID 5799110334, 2 clinicians

Practice addresses (Care Compare)

38800 Garfield Rd
Suite 100
Clinton Township, MI 48038-6619
Phone (586) 231-0306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801109737MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Professional Services CurrentSince Feb 14, 2025 Accepting new patients

Locations

38800 Garfield Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 231-0306

2425 S Linden Rd
Ste D118
Flint, MI 48532
Phone (248) 731-8045

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1215502265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38800 GARFIELD RD STE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386619",
            "telephone_number": "586-231-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38800 GARFIELD RD STE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386619",
            "telephone_number": "586-231-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTIMIGLIA",
        "first_name": "DESTINY",
        "middle_name": "RAE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801109737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.