Individual provider Active NPI

Sylvia Carruth, LMSW

  • Clinical Social Worker
  • Ypsilanti, MI
National Provider Identifier
1396917886
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801064193 Issued in MI
Practice address
459 Dupont Ave
Ypsilanti, MI 48197-1911
Phone
(734) 657-1351
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 6801064193 MI Primary

Addresses

Primary practice location

459 Dupont Ave
Ypsilanti, MI 48197-1911

Mailing address

459 Dupont Ave
Ypsilanti, MI 48197-1911
Phone (734) 657-1351

Other identifiers 1

IdentifierTypeStateIssuer
750910829OtherMIBCBSM

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
I20150915000277 MI Practitioner - Clinical Social Worker 1456668037 Practice locations: Ypsilanti, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

459 Dupont Ave
Ypsilanti, MI 48197-1911
Phone (734) 657-1351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801064193MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1396917886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 DUPONT AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971911",
            "telephone_number": "734-657-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 DUPONT AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971911",
            "telephone_number": "734-657-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTH",
        "first_name": "SYLVIA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801064193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "750910829",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.