Deanna O'Dea, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801033897 Issued in MI

Practice address

640 Griswold St
Suite 300
Northville, MI 48167-1690

Phone

(248) 348-1100

Fax

(248) 348-3410

NPI assigned

Dec 20, 2014

Last updated

Dec 20, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1419033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419033600000",
    "number": "1326446519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 GRISWOLD ST",
            "address_2": "SUITE 300",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671690",
            "telephone_number": "248-348-1100",
            "fax_number": "248-348-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 GRISWOLD ST",
            "address_2": "SUITE 300",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671690",
            "telephone_number": "248-348-1100",
            "fax_number": "248-348-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DEA",
        "first_name": "DEANNA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-20",
        "last_updated": "2014-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801033897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC TAX ID",
            "identifier": "382695674",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1801083183",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northville Pain Specialists PLC
• Northville Pharmacy LLC (Northville Pharmacy)
• Northville Physical Rehabilitation, P.C.
• Northville Vision Clinic PC
• Kim Nwagwu, IMH-E
• Nolan O'Hara
• Viktoria Mladenovik Odryna, MD
• Vineeta Ohri, PT
• Venkata Ojili
• Nneoma Okorafor

• Clinical Social Worker in Northville, MI
• Providers in Northville, 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 Dec 20, 2014; 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.