Active NPI
Madeline Gail Tenenbaum, LICENSED MASTER'S SO
- Clinical Social Worker
- West Bloomfield, MI
National Provider Identifier
1437774197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801106415
- Practice address
- 6800 W. Maple Rd.
West Bloomfield, MI 48322 - Phone
- (248) 788-5300
- NPI assigned
- Jun 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801106415 | MI | Primary |
Addresses
Primary practice location
6800 W. Maple Rd.
West Bloomfield, MI 48322
Mailing address
25168 Ridgecliff Drive
Southfield, MI 48075
Phone (248) 514-7083
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210112003106 | MI | Practitioner - Clinical Social Worker | 2668885666 | Practice locations: Southfield, MI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801106415 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1437774197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25168 RIDGECLIFF DRIVE",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48075",
"telephone_number": "248-514-7083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 W. MAPLE RD.",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "48322",
"telephone_number": "248-788-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENENBAUM",
"first_name": "MADELINE",
"middle_name": "GAIL",
"name_prefix": "Mrs.",
"credential": "LICENSED MASTER'S SO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-09",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801106415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.