Individual provider Active NPI

Tiffiany S Haywood

  • Clinical Social Worker
  • Flint, MI
National Provider Identifier
1245929561
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801115751 Issued in MI
Practice address
1040 W Bristol Rd
Flint, MI 48507-5516
Phone
(810) 496-5562
NPI assigned
May 3, 2023
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6801115751 MI
Mental Health Counselor 101YM0800X MI
Mental Health Counselor 101YM0800X 6801115751 MI
Clinical Social Worker 1041C0700X 6801115751
Clinical Social Worker 1041C0700X 6801115751 MI Primary
Community Health Worker 172V00000X 6801115751 MI
Behavior Analyst 103K00000X 6801115751 MI
Case Manager/Care Coordinator 171M00000X 6801115751 MI
Psychoanalyst 102L00000X 6801115751 MI
Health & Wellness Coach 171400000X 6801115751 MI

Addresses

Primary practice location

1040 W Bristol Rd
Flint, MI 48507-5516

Mailing address

329 Leta Ave
Flint, MI 48507-2727
Phone (601) 896-7656

Other practice location 1

Midwest Behavioral Clinic
8308 Office Park Dr #3,
Grand Blanc, MI 48439
Phone (810) 215-1006

Other practice location 2

2109 Martin Luther King Ave
Flint, MI 48503-1027
Phone (810) 335-5366

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
I20240712002750 MI Practitioner - Clinical Social Worker 0749725836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Behavioral Clinic LLCGroup PAC ID 0446503130, 13 clinicians

Practice addresses (Care Compare)

210 W Highland Rd
Suite 102
Highland, MI 48357-4573
Phone (248) 529-3167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Behavioral Clinic LLC CurrentSince Jun 1, 2024 Accepting new patients
Genesee Health System Past Accepting new patients
Creekside Counseling Group LLC Counselor PastSince Dec 19, 2023 Accepting new patients

Locations

210 W Highland Rd
Ste 102
Highland, MI 48357
Phone (248) 529-3167

Organizations & group practices 3

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1245929561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 LETA AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072727",
            "telephone_number": "601-896-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485075516",
            "telephone_number": "810-496-5562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Midwest Behavioral Clinic",
            "address_2": "8308 Office Park Dr #3,",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "48439",
            "country_code": "US",
            "telephone_number": "810-215-1006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2109 Martin Luther King Ave",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485031027",
            "country_code": "US",
            "telephone_number": "810-335-5366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "TIFFIANY",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115751",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "MI",
            "license": "6801115751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.