Active NPI
Domenique Nash
- Social Worker
- Southfield, MI
National Provider Identifier
1295486918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 24600 Northwestern Hwy
Southfield, MI 48075-2471 - Phone
- (313) 790-2164
- NPI assigned
- Jan 13, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
24600 Northwestern Hwy
Southfield, MI 48075-2471
Mailing address
8301 16 1/2 Mile Rd Apt 55
Sterling Heights, MI 48312-1850
Phone (313) 790-2164
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000000000000000 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/A | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699315200000",
"number": "1295486918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8301 16 1/2 MILE RD APT 55",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483121850",
"telephone_number": "313-790-2164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24600 NORTHWESTERN HWY",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752471",
"telephone_number": "313-790-2164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "DOMENIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-13",
"last_updated": "2023-11-07",
"certification_date": "2023-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000000000000000000",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"endpointDescription": "N/A",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "24600 Northwestern Hwy",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480752471",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.