Individual provider Active NPI

Elizabeth Luidens, LLMSW

  • Clinical Social Worker
  • Saint Clair Shores, MI
National Provider Identifier
1376306209
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851117736 Issued in MI
Practice address
21611 E 11 Mile Rd
Saint Clair Shores, MI 48081-1636
Phone
(586) 944-2902
NPI assigned
Feb 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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 6851117736 MI Primary

Addresses

Primary practice location

21611 E 11 Mile Rd
Saint Clair Shores, MI 48081-1636

Mailing address

3697 Lakepointe St
Detroit, MI 48224-3357
Phone (616) 550-3099

Other practice location 1

1861 E Maple Rd
Troy, MI 48083-4207
Phone (248) 246-0172

Other names 1

  • Lyz Luidens Other name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851117736MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
MCTS Rose, LLC Clinical PastSince Mar 12, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1376306209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3697 LAKEPOINTE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482243357",
            "telephone_number": "616-550-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21611 E 11 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811636",
            "telephone_number": "586-944-2902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1861 E Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480834207",
            "country_code": "US",
            "telephone_number": "248-246-0172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUIDENS",
        "first_name": "ELIZABETH",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851117736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYZ",
            "last_name": "LUIDENS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.