Individual provider Active NPI

Wynter Joi Wyrick, LCSW

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1255587374
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114902 Issued in MI
Practice address
29201 Telegraph Rd Ste 550
Southfield, MI 48034-7664
Phone
(734) 737-1200
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801114902 MI Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

29201 Telegraph Rd Ste 550
Southfield, MI 48034-7664

Mailing address

29201 Telegraph Rd Ste 550
Southfield, MI 48034-7664
Phone (313) 758-0150

Other practice location 1

5555 Conner St
Detroit, MI 48213-3448
Phone (313) 308-0255 ext. 305

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
I20230526000119 MI Practitioner - Clinical Social Worker 2365808854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
St. Louis College of Physicians and Surgeons, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

29201 Telegraph Rd
Suite 550
Southfield, MI 48034-7664
Phone (248) 213-0501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801114902MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jan 4, 2025 Accepting new patients
Wyrick Wellness Consultants, LLC Current Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jan 4, 2025 Accepting new patients
Alpha Family Counseling PC Clinical CurrentSince May 24, 2023 Accepting new patients

Locations

43996 Woodward Ave
Ste 2
Bloomfield Township, MI 48302
Phone (248) 489-4011

29201 Telegraph Rd
Ste 550
Southfield, MI 48034
Phone (248) 213-0501

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1255587374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD STE 550",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347664",
            "telephone_number": "313-758-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD STE 550",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347664",
            "telephone_number": "734-737-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Conner St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482133448",
            "country_code": "US",
            "telephone_number": "313-308-0255 x305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYRICK",
        "first_name": "WYNTER",
        "middle_name": "JOI",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114902",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.