Individual provider Active NPI

Elizabeth Gaydayenko, LLMSW

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1255228045
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851120299 Issued in MI
Practice address
24600 Northwestern Hwy
Southfield, MI 48075-2471
Phone
(248) 745-4900
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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 6851120299 MI Primary

Addresses

Primary practice location

24600 Northwestern Hwy
Southfield, MI 48075-2471

Mailing address

167 Old Perch Rd
Rochester Hills, MI 48309-2135
Phone (248) 942-1646

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
6851120299MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CNS Healthcare PastSince Jun 29, 2025 Accepting new patients

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": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1255228045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 OLD PERCH RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483092135",
            "telephone_number": "248-942-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24600 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752471",
            "telephone_number": "248-745-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYDAYENKO",
        "first_name": "ELIZABETH",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851120299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.