Active NPI
Kristen Richardson
- Social Worker
- Detroit, MI
National Provider Identifier
1356727036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801094727
- Practice address
- 4160 Woodward Avenue
2ND Floor
Detroit, MI 48201 - Phone
- (313) 656-4052
- NPI assigned
- Aug 5, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801094727 | MI | Primary |
Addresses
Primary practice location
4160 Woodward Avenue
2ND Floor
Detroit, MI 48201
Mailing address
3602 Dykeman
Fort Gratiot, MI 48059
Phone (810) 956-0661
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1322 River Rd
Saint Clair, MI 48079-2803
Phone (810) 329-4798
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imagine Center LLC | Past | Accepting new patients | |
| St Clair County Community Mental Health Authority | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Mental Health Counselor
- Saint Clair, MI
- NPI 1619934650
-
- Clinical Psychologist
- Northville, MI
- NPI 1467899666
-
- Community/Behavioral Health Agency
- Marine City, MI
- NPI 1821133265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1356727036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3602 DYKEMAN",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "48059",
"telephone_number": "810-956-0661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 WOODWARD AVENUE",
"address_2": "2ND FLOOR",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-656-4052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801094727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.