Individual provider Active NPI

Guam M Lee I, LLMSW

  • Clinical Social Worker
  • Redford, MI
National Provider Identifier
1376067488
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093285 Issued in MI
Practice address
26520 Grand River Ave
Redford, MI 48240-1506
Phone
(313) 533-5652
Fax
(313) 533-5644
NPI assigned
Jul 31, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801093285 MI Primary

Addresses

Primary practice location

26520 Grand River Ave
Redford, MI 48240-1506

Mailing address

26520 Grand River Ave Ste 121
Redford, MI 48240-1506
Phone (313) 533-5652

Other practice location 1

26520 Grand River Ave Suite 121
Redford, MI 48240-1506
Phone (313) 533-5652

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180320003296 MI Practitioner - Clinical Social Worker 7810259371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Angel Counseling Inc.Group PAC ID 9436114568, 4 clinicians

Practice addresses (Care Compare)

26520 Grand River Ave
Suite 121
Redford, MI 48240-1506
Phone (313) 533-5652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093285MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Counseling Inc. Clinical CurrentSince Mar 17, 2018 Accepting new patients
A Better Tomorrow Counseling and Consultation Services, LLC CurrentSince Feb 14, 2018 Accepting new patients

Locations

24801 5 Mile Rd
Ste 7
Redford, MI 48239
Phone (248) 281-3862

26520 Grand River Ave
Redford, MI 48240
Phone (313) 533-5652

26520 Grand River Ave
Ste 121
Redford, MI 48240
Phone (313) 533-5652

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376067488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 GRAND RIVER AVE STE 121",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401506",
            "telephone_number": "313-533-5652",
            "fax_number": "313-533-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 GRAND RIVER AVE",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401506",
            "telephone_number": "313-533-5652",
            "fax_number": "313-533-5644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26520 Grand River Ave Suite 121",
            "address_purpose": "LOCATION",
            "city": "Redford",
            "state": "MI",
            "postal_code": "482401506",
            "country_code": "US",
            "telephone_number": "313-533-5652",
            "fax_number": "313-533-5644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "GUAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

Verify at the official NPI Registry.