Tiffany Mickens, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088095 Issued in NY

Practice address

24230 Karim Blvd Ste 100
Novi, MI 48375-2960

Phone

(248) 745-4900

NPI assigned

Nov 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1417614280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 CREEK BOTTOM RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300526665",
            "telephone_number": "347-575-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24230 KARIM BLVD STE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752960",
            "telephone_number": "248-745-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKENS",
        "first_name": "TIFFANY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Pain Management Consultants-West, PC
• Michigan Pain Management Consultants, PC Naapn
• Michigan Respiratory and Sleep Physicians PLLC
• Michigan Surgery Specialists P.C.
• Stephanie Mickens
• Sherri Middaugh
• Lucretia Middlebrooks
• Steven Ronald Migdalewicz, DPM
• Diana Mihailovich
• Connor Mikula

• Clinical Social Worker in Novi, MI
• Providers in Novi, 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 Nov 29, 2021; 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.