Tri-Care PC. Dba Northland Clinic

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801000531 Issued in MI

Legal business name

TRI-CARE PC. DBA NORTHLAND CLINIC

Doing business as

Northland Clinic

Practice address

20300 Civic Center Dr
Ste. 303
Southfield, MI 48076-4105

Phone

(248) 559-8190

Fax

(248) 559-8776

NPI assigned

Apr 5, 2011

Last updated

Apr 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Louis Goldman, LMSW

Title

Co-Director

Phone

(248) 559-8190

Specialties & licenses 1

Addresses

Other names 1

• Northland Clinic Doing business as

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1366731879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20300 CIVIC CENTER DR",
            "address_2": "STE. 303",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764105",
            "telephone_number": "248-559-8190",
            "fax_number": "248-559-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20300 CIVIC CENTER DR",
            "address_2": "STE. 303",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764105",
            "telephone_number": "248-559-8190",
            "fax_number": "248-559-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CARE PC. DBA NORTHLAND CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "248-559-8190",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801000531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northland Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Treehouse ABA
• Kelly Danielle Treharne, LLPC
• Trend Care LLC (Trend Care Home Health)
• Valerie Trevino
• Tri Star Residential Inc
• Tri-County Imaging Center Inc.
• Triangels Home Health Care Inc
• Tricity Laboratory, LLC
• Kristen Leigh Trierweiler
• Shawntierea Irene Trimble, LMSW

• Clinical Social Worker in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.