Active NPI
John Latham
- Clinical Social Worker
- Ann Arbor, MI
National Provider Identifier
1275191306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S.0027743
- Practice address
- 410 E Jefferson St
Ann Arbor, MI 48104-2311 - Phone
- (734) 439-2922
- NPI assigned
- Jun 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S.0027743 | OH | Primary |
| Clinical Social Worker | 1041C0700X | 6802073603 | MI |
Addresses
Primary practice location
410 E Jefferson St
Ann Arbor, MI 48104-2311
Mailing address
410 E Jefferson St
Ann Arbor, MI 48104-2311
Phone (734) 439-2922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6802073603 | Other | MI | SOCIAL WORK LICENSE THROUGH MICHIGAN DEPARTMENT OF CONSUMER & INDUSTRY SERVICES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6802073603 | MI | MD | Clinical Social Worker |
| S.0027743 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1275191306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 E JEFFERSON ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042311",
"telephone_number": "734-439-2922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 E JEFFERSON ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042311",
"telephone_number": "734-439-2922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-04",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S.0027743",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6802073603",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK LICENSE THROUGH MICHIGAN DEPARTMENT OF CONSUMER & INDUSTRY SERVICES",
"identifier": "6802073603",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.