Individual provider Active NPI

Sandra Overstreet-Ware, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1376706069
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801020425 Issued in MI
Practice address
3815 W Fort St
Detroit, MI 48216
Phone
(313) 510-6189
Fax
(313) 393-7883
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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 6801020425 MI Primary

Addresses

Primary practice location

3815 W Fort St
Detroit, MI 48216

Mailing address

1300 Lafayette East
Suite 2001
Detroit, MI 48207
Phone (313) 510-6189

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801020425MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1376706069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 LAFAYETTE EAST",
            "address_2": "SUITE 2001",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48207",
            "telephone_number": "313-510-6189",
            "fax_number": "313-393-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 W FORT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48216",
            "telephone_number": "313-510-6189",
            "fax_number": "313-393-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET-WARE",
        "first_name": "SANDRA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801020425",
            "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 Dec 21, 2017; 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.