Active NPI
Andrea Nitzkin, LMSW
- Clinical Social Worker
- Farmington Hills, MI
National Provider Identifier
1366623373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801088377
- Practice address
- 28592 Orchard Lake Rd
Farmington Hills, MI 48334-2961 - Phone
- (248) 592-7072
- NPI assigned
- Nov 19, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801088377 | MI | Primary |
Addresses
Primary practice location
28592 Orchard Lake Rd
Farmington Hills, MI 48334-2961
Mailing address
6555 W Maple Rd
West Bloomfield, MI 48322-4926
Phone (248) 592-2300
Other practice location 1
42450 W 12 Mile Rd Ste 315
Novi, MI 48377-3030
Phone (248) 513-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801088377 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1366623373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6555 W MAPLE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483224926",
"telephone_number": "248-592-2300",
"fax_number": "248-592-2340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28592 ORCHARD LAKE RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342961",
"telephone_number": "248-592-7072"
}
],
"practiceLocations": [
{
"address_1": "42450 W 12 Mile Rd Ste 315",
"address_purpose": "LOCATION",
"city": "Novi",
"state": "MI",
"postal_code": "483773030",
"country_code": "US",
"telephone_number": "248-513-4100",
"fax_number": "248-513-4105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NITZKIN",
"first_name": "ANDREA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-19",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801088377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.