Active NPI
Jeremy Goetz, L.L.M.S.W.
- Social Worker
- Sterling Heights, MI
National Provider Identifier
1285959619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801091901
- Practice address
- 2122 15 Mile Rd
Suite B
Sterling Heights, MI 48310-4853 - Phone
- (586) 264-3692
- NPI assigned
- Mar 29, 2010
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801091901 | MI | Primary |
Addresses
Primary practice location
2122 15 Mile Rd
Suite B
Sterling Heights, MI 48310-4853
Mailing address
2951 Bolingbroke Dr
Troy, MI 48084-1067
Phone (586) 549-8320
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801091901 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1285959619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2951 BOLINGBROKE DR",
"city": "TROY",
"state": "MI",
"postal_code": "480841067",
"telephone_number": "586-549-8320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2122 15 MILE RD",
"address_2": "SUITE B",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483104853",
"telephone_number": "586-264-3692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETZ",
"first_name": "JEREMY",
"name_prefix": "Mr.",
"credential": "L.L.M.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-29",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801091901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.