Individual provider Active NPI

Tricia Louise Wilder, LMSW

  • Clinical Social Worker
  • Novi, MI
National Provider Identifier
1336971878
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801071244 Issued in MI
Practice address
44725 Grand River Ave Ste 104
Novi, MI 48375-1024
Phone
(248) 846-8345
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801071244 MI Primary

Addresses

Primary practice location

44725 Grand River Ave Ste 104
Novi, MI 48375-1024

Mailing address

21644 Mayfield St
Farmington Hills, MI 48336-4524
Phone (248) 893-7483

Other names 1

  • Tricia Louise Kramer Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250129001167 MI Practitioner - Clinical Social Worker 7810426319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

44725 Grand River Ave
Suite 104
Novi, MI 48375-1024
Phone (734) 285-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801071244MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Nov 17, 2024 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Nov 17, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

44725 Grand River Ave
Ste 104
Novi, MI 48375
Phone (248) 846-8345

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1336971878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21644 MAYFIELD ST",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483364524",
            "telephone_number": "248-893-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024",
            "telephone_number": "248-846-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "TRICIA",
        "middle_name": "LOUISE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801071244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "KRAMER",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.