NPIMap

Organization Active NPI

Life Star of Michigan LLC

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1346577947
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801084742 Issued in MI
Legal business name
LIFE STAR OF MICHIGAN LLC
Practice address
40400 Ann Arbor Rd E Ste 104a
Plymouth, MI 48170-6611
Phone
(734) 416-5000
NPI assigned
Nov 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Authorized official

Name
Mrs. Kathie Schofield, LMSW
Title
Clinical Director
Phone
(734) 416-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801084742 MI Primary

Addresses

Primary practice location

40400 Ann Arbor Rd E Ste 104a
Plymouth, MI 48170-6611

Mailing address

40400 Ann Arbor Rd E Ste 104a
Plymouth, MI 48170-6611
Phone (734) 416-5000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1346577947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40400 ANN ARBOR RD E STE 104A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706611",
            "telephone_number": "734-416-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40400 ANN ARBOR RD E STE 104A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706611",
            "telephone_number": "734-416-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE STAR OF MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-03",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "SCHOFIELD",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "734-416-5000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801084742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; 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.