Individual provider Active NPI

Wendy Nicole Myers-Cromwell, LMSW

  • Clinical Social Worker
  • Dearborn, MI
National Provider Identifier
1356491617
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081669 Issued in MI
Practice address
19855 Outer Dr Ste 104W
Dearborn, MI 48124-2027
Phone
(313) 971-7822
NPI assigned
Jan 11, 2007
Last updated
Dec 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801081669 MI Primary
School Social Worker 1041S0200X 6801081669 MI

Addresses

Primary practice location

19855 Outer Dr Ste 104W
Dearborn, MI 48124-2027

Mailing address

1063 Trevor PL
Detroit, MI 48207-3809
Phone (313) 971-7822

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
6801081669MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1356491617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 TREVOR PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482073809",
            "telephone_number": "313-971-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19855 OUTER DR STE 104W",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242027",
            "telephone_number": "313-971-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS-CROMWELL",
        "first_name": "WENDY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081669",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "6801081669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.