Jaimmie Ilana Witucki, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801105488 Issued in MI

Practice address

625 E Big Beaver Rd Ste 200
Troy, MI 48083-1434

Phone

(586) 863-4000

NPI assigned

Sep 24, 2019

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

Other names 1

• Miss Jaimmie Ilana Koss Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeline Medical CenterGroup PAC ID 3678948577, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifeline Medical Center

  • Family Medicine Physician
  • Anderson, IN
  • NPI 1265160451

  MI

  Medicare reassignment Care Compare group NPD
• Northstar Mental Health

  • Clinical Social Worker
  • Davidsville, PA
  • NPI 1790623619

  MI

  Medicare reassignment
• Hetal Patel, M.D. P.C.

  • Psychiatry Physician
  • Chesterfield, MI
  • NPI 1447672944
  NPD
• Henry Ford Health System

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1891702833
  NPD (past)

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1326699182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23741 REYNOLDS AVE",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301448",
            "telephone_number": "248-798-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BIG BEAVER RD STE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831434",
            "telephone_number": "586-863-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITUCKI",
        "first_name": "JAIMMIE",
        "middle_name": "ILANA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIMMIE",
            "last_name": "KOSS",
            "middle_name": "ILANA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robin Kelly Winke, LMSW
• Wisdom Life & Business Coaching Services, LLC
• Wise Medical Staffing, Inc.
• Courtney Ann Witczak, PT, DPT, GCS
• Victor George Wittkowski, DDS
• Delaney Witz
• Alexander Wizner, LLBSW
• Nathan A Wloch, PA
• Nadine Wodwaski, DNP, MSN-ED, ACNS, R
• Meagan Maxie Woerner

• Clinical Social Worker in Troy, MI
• Providers in Troy, 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 Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.