Realizing Your Potential LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REALIZING YOUR POTENTIAL LLC

Doing business as

Realizing Your Potential LLC

Practice address

9045 Kinloch
Redford, MI 48239-1885

Phone

(248) 636-7434

NPI assigned

Dec 20, 2023

Last updated

Dec 20, 2023By 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

Jacqueline Kaba, LMSWNPI 1104160837

Title

Owner

Phone

(248) 636-7434

Specialties & licenses 1

Addresses

Other names 1

• Realizing Your Potential LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Anne Kaba, LMSW

  • Clinical Social Worker
  • Taylor, MI
  • NPI 1104160837
  NPD Authorized official

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1407624307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 KINLOCH",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391885",
            "telephone_number": "248-636-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 KINLOCH",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391885",
            "telephone_number": "248-636-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALIZING YOUR POTENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "KABA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-636-7434",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Realizing Your Potential LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Lynn Ray, LPC
• Brenae Latrece Rayborn, NURSING ASSISTANT
• Kimberly Raynor
• RC Therapeutic Solutions
• Real Place Inc.
• Donna Recor, BS, RSST
• Gail Redden, LBSW
• Redford Chiropractic Center PC
• Redford Counseling
• Redford Dental Group

• Clinical Social Worker in Redford, MI
• Providers in Redford, 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 Dec 20, 2023; 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.