Individual provider Active NPI

Joanne Terry, LMSW

  • Clinical Social Worker
  • South Lyon, MI
National Provider Identifier
1336479005
Registry record updated Oct 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801016192 Issued in MI
Practice address
22220 Quail Run Cir Unit 1
South Lyon, MI 48178-2608
Phone
(248) 446-3094
NPI assigned
Jan 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 6801016192 MI
Psychiatric Hospital 283Q00000X 6801016192 MI
Clinical Social Worker 1041C0700X 6801016192 MI Primary
Community/Behavioral Health Agency 251S00000X 6801016192 MI

Addresses

Primary practice location

22220 Quail Run Cir Unit 1
South Lyon, MI 48178-2608

Mailing address

22220 Quail Run Cir Unit 1
South Lyon, MI 48178-2608
Phone (248) 446-3094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801016192MIMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1262304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287187200000",
    "number": "1336479005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22220 QUAIL RUN CIR UNIT 1",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481782608",
            "telephone_number": "248-446-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22220 QUAIL RUN CIR UNIT 1",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481782608",
            "telephone_number": "248-446-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "JOANNE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-01",
        "last_updated": "2010-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "6801016192",
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MI",
            "license": "6801016192",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801016192",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801016192",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

Verify at the official NPI Registry.