Individual provider Active NPI

Kevin Rose, LMSW

  • Clinical Social Worker
  • Taylor, MI
National Provider Identifier
1245369057
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801034072 Issued in MI
Practice address
26650 Eureka Rd Ste a
Taylor, MI 48180-4835
Phone
(734) 955-3550
NPI assigned
Mar 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 6801034072 MI Primary

Addresses

Primary practice location

26650 Eureka Rd Ste a
Taylor, MI 48180-4835

Mailing address

26650 Eureka Rd Ste a
Taylor, MI 48180-4835
Phone (734) 955-3550

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
I20160517002420 MI Practitioner - Clinical Social Worker 1850680604 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17387 Brody Ave
Allen Park, MI 48101-3417

7000 Roosevelt Ave
Suite 203
Allen Park, MI 48101-2583
Phone (734) 776-1605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801034072MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hegira Health, Inc. CurrentSince Mar 21, 2022 Accepting new patients
Hegira Health, Inc Clinical CurrentSince Mar 21, 2022 Accepting new patients
Kevin Rose PLLC Clinical CurrentSince Oct 23, 2019 Accepting new patients
The Guidance Center CurrentSince May 29, 2019 Accepting new patients

Locations

7000 Roosevelt Ave
Ste 203
Allen Park, MI 48101
Phone (248) 760-3125

26184 Outer Dr
Lincoln Park, MI 48146
Phone (313) 389-7500

37450 Schoolcraft Rd
Ste 110
Livonia, MI 48150
Phone (734) 458-4611

19291 Northline Rd
Southgate, MI 48195
Phone (734) 287-1500

13101 Allen Rd
Southgate, MI 48195
Phone (734) 785-7701

26650 Eureka Rd
Ste A
Taylor, MI 48180
Phone (313) 389-7500

8623 N Wayne Rd
Ste 123
Westland, MI 48185
Phone (734) 367-0469

Organizations & group practices 4

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245369057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26650 EUREKA RD STE A",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804835",
            "telephone_number": "734-955-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26650 EUREKA RD STE A",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804835",
            "telephone_number": "734-955-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.