Active NPI
Takila Simmons
- Clinical Social Worker
- Flint, MI
National Provider Identifier
1255750709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 68801091465
- Practice address
- 129 E 3Rd St
Flint, MI 48502-1728 - Phone
- (810) 233-4031
- NPI assigned
- Apr 14, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 68801091465 | MI | Primary |
Addresses
Primary practice location
129 E 3Rd St
Flint, MI 48502-1728
Mailing address
3309 Sunset Dr
Flint, MI 48503-2363
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68801091465 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397433600000",
"number": "1255750709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3309 SUNSET DR",
"city": "FLINT",
"state": "MI",
"postal_code": "485032363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 E 3RD ST",
"city": "FLINT",
"state": "MI",
"postal_code": "485021728",
"telephone_number": "810-233-4031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "TAKILA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-14",
"last_updated": "2014-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "68801091465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.