Individual provider Active NPI

Patricia Ann Dulka, LMSW ACSW

  • Clinical Social Worker
  • Adrian, MI
National Provider Identifier
1336267632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68010734334 Issued in MI
Practice address
199 N Broad St
Adrian, MI 49221-2762
Phone
(517) 263-2191
Fax
(517) 264-6080
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 68010734334 MI Primary

Addresses

Primary practice location

199 N Broad St
Adrian, MI 49221-2762

Mailing address

707 E Siena Heights Dr
Apt 7
Adrian, MI 49221-1766
Phone (517) 266-2521

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
68010734334MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336267632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E SIENA HEIGHTS DR",
            "address_2": "APT 7",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211766",
            "telephone_number": "517-266-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 N BROAD ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212762",
            "telephone_number": "517-263-2191",
            "fax_number": "517-264-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULKA",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LMSW ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "68010734334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, 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.