Individual provider Active NPI

Deniquia Denisze Berry-Golston, LLMSW

  • Social Worker
  • Fort Gratiot, MI
National Provider Identifier
1245947084
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851115739 Issued in MI
Practice address
1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone
(810) 985-5125
NPI assigned
Nov 1, 2022
Last updated
Nov 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851115739 MI Primary

Addresses

Primary practice location

1501 Krafft Rd
Fort Gratiot, MI 48059-3565

Mailing address

1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125

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

LicenseStateTypeSpecialty
6851115739MIMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1245947084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KRAFFT RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593565",
            "telephone_number": "810-985-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KRAFFT RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593565",
            "telephone_number": "810-985-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY-GOLSTON",
        "first_name": "DENIQUIA",
        "middle_name": "DENISZE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851115739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.