Individual provider Active NPI

Tiffany Lamara Jones-Bolek-Toubeaux, LLMSW

  • Social Worker
  • Southgate, MI
National Provider Identifier
1326504671
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801102691 Issued in MI
Practice address
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Phone
(734) 324-8326
NPI assigned
Feb 12, 2019
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801102691 MI Primary
Clinical Social Worker 1041C0700X 6801102691 MI

Addresses

Primary practice location

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Mailing address

1808 Buckingham Ave
Lincoln Park, MI 48146-3508
Phone (313) 918-5876

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

State licenses

LicenseStateTypeSpecialty
6801102691MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1326504671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 BUCKINGHAM AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463508",
            "telephone_number": "313-918-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES-BOLEK-TOUBEAUX",
        "first_name": "TIFFANY",
        "middle_name": "LAMARA",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801102691",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.