Individual provider Active NPI

Walter Edward Jurewicz, MSW

  • Clinical Social Worker
  • West Bloomfield, MI
National Provider Identifier
1306909049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801015640 Issued in MI
Practice address
6050 Cherry Crest Dr
West Bloomfield, MI 48322-1720
Phone
(248) 865-3389
NPI assigned
Dec 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801015640 MI Primary

Addresses

Primary practice location

6050 Cherry Crest Dr
West Bloomfield, MI 48322-1720

Mailing address

6050 Cherry Crest Dr
West Bloomfield, MI 48322-1720
Phone (248) 865-3389

Other identifiers 1

IdentifierTypeStateIssuer
68010115640OtherMISOCIAL WORKER

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

State licenses

LicenseStateTypeSpecialty
6801015640MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306909049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 CHERRY CREST DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221720",
            "telephone_number": "248-865-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 CHERRY CREST DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221720",
            "telephone_number": "248-865-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUREWICZ",
        "first_name": "WALTER",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801015640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER",
            "identifier": "68010115640",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.