Active NPI
Mead Goedert, LMSW
- Clinical Social Worker
- Royal Oak, MI
National Provider Identifier
1285920181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801089319
- Practice address
- 415 S West St
Suite 150
Royal Oak, MI 48067-2521 - Phone
- (313) 850-0469
- NPI assigned
- Jun 20, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801089319 | MI | Primary |
Addresses
Primary practice location
415 S West St
Suite 150
Royal Oak, MI 48067-2521
Mailing address
415 S West St
Suite 150
Royal Oak, MI 48067-2521
Phone (313) 850-0469
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 |
|---|---|---|---|
| 6801089319 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1285920181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S WEST ST",
"address_2": "SUITE 150",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672521",
"telephone_number": "313-850-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S WEST ST",
"address_2": "SUITE 150",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672521",
"telephone_number": "313-850-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEDERT",
"first_name": "MEAD",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-20",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801089319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.