Individual provider Active NPI

Latanya Richardson, LMSW

  • Clinical Social Worker
  • Ypsilanti, MI
National Provider Identifier
1336566512
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119419 Issued in MI
Practice address
555 Towner St
Ypsilanti, MI 48198
Phone
(734) 544-3071
Fax
(734) 544-6732
NPI assigned
Mar 25, 2014
Last updated
Dec 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802087343 MI
Social Worker 104100000X 6801099112 MI
Clinical Social Worker 1041C0700X 6801119419 MI Primary

Addresses

Primary practice location

555 Towner St
Ypsilanti, MI 48198

Mailing address

21700 Northwesten Hwy
Suite 501
Southfield, MI 48075-4922
Phone (313) 210-4158

Other practice location 1

555 Towner St
Ypsilanti, MI 48198
Phone (734) 544-3071

Other practice location 2

21700 Northwesten Hwy
Suite 501
Southfield, MI 48075-4922
Phone (313) 210-4158

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
6801099112MIMDSocial Worker
6802087343MIMDSocial Worker
6801119419MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Path Solutions PLLC Clinical Current Accepting new patients

Locations

21700 Northwestern Hwy
Southfield, MI 48075
Phone (248) 556-9156

21700 Northwestern Hwy
Ste 500
Southfield, MI 48075

21700 Northwestern Hwy
Ste 501
Southfield, MI 48075
Phone (313) 210-4158

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1336566512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21700 NORTHWESTEN HWY",
            "address_2": "SUITE 501",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754922",
            "telephone_number": "313-210-4158",
            "fax_number": "734-544-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48198",
            "telephone_number": "734-544-3071",
            "fax_number": "734-544-6732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Towner St",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "48198",
            "country_code": "US",
            "telephone_number": "734-544-3071",
            "fax_number": "734-544-6732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21700 Northwesten Hwy",
            "address_2": "Suite 501",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754922",
            "country_code": "US",
            "telephone_number": "313-210-4158",
            "fax_number": "734-544-6716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LATANYA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802087343",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801099112",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.