Individual provider Active NPI

Deanna Marie Iverson, LMSW

  • Clinical Social Worker
  • Northville, MI
National Provider Identifier
1265054837
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801107374 Issued in MI
Practice address
315 N Center St
Northville, MI 48167-1277
Phone
(313) 656-4052
Fax
(313) 656-4053
NPI assigned
May 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 6801107374 MI Primary

Addresses

Primary practice location

315 N Center St
Northville, MI 48167-1277

Mailing address

2054 Wickham St
Royal Oak, MI 48073-1164
Phone (313) 598-2295

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
I20240327003863 MI Practitioner - Clinical Social Worker 7214374016 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801107374MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Macomb CurrentSince Oct 1, 2024 Accepting new patients
Mindsafe, PLLC Current Accepting new patients
Easterseals Morc Health Care, Inc. CurrentSince Feb 22, 2024 Accepting new patients
County of Macomb CurrentSince Oct 1, 2024 Accepting new patients
Pobody Is Nerfect PastSince Mar 11, 2025 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

6900 E 10 Mile Rd
Center Line, MI 48015
Phone (586) 501-3070

19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

Organizations & group practices 5

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": "1589673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1265054837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 WICKHAM ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731164",
            "telephone_number": "313-598-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N CENTER ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671277",
            "telephone_number": "313-656-4052",
            "fax_number": "313-656-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "DEANNA",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-17",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801107374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

Verify at the official NPI Registry.