Individual provider Active NPI

Linda Mariw Dati, L.M.S.W.

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1275868077
Registry record updated Oct 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801046345 Issued in MI
Practice address
4112 Outlook Blvd
Pueblo, CO 81008-1667
Phone
(586) 466-5956
NPI assigned
Oct 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2009

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 6801046345 MI Primary

Addresses

Primary practice location

4112 Outlook Blvd
Pueblo, CO 81008-1667

Mailing address

38370 Maple Forest Blvd E
Harrison Township, MI 48045-2213
Phone (586) 466-5956

Other names 1

  • Linda Marie Dati Professional name

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
6801046345MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1275868077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38370 MAPLE FOREST BLVD E",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480452213",
            "telephone_number": "586-466-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "586-466-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATI",
        "first_name": "LINDA",
        "middle_name": "MARIW",
        "credential": "L.M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801046345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "DATI",
            "middle_name": "MARIE",
            "credential": "L.M.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; 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.