Mary Kathryn Bicknell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801100260 Issued in MI

Practice address

17421 Telegraph Rd
Detroit, MI 48219-3165

Phone

(313) 531-2500

NPI assigned

Jan 31, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1295366995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43715 SIMSBURY ST",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872710",
            "telephone_number": "770-815-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17421 TELEGRAPH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193165",
            "telephone_number": "313-531-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKNELL",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanushri Bhushan, MD, MPH
• Ladanna Bibb
• Rehana Bibi
• Samara Bibi, RN
• Andrea Elizabeth Bice, MSW, LICSW, DDMHS
• Kurt Michael Biebuyck, PHYSICAL THERAPIST
• Janine Bieda, CNM
• Melanie Ann Bieganski
• Brenda Bierenga, FNP, BC
• Big D Corp

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.