Beata Jedrzejczyk, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851106927 Issued in MI

Practice address

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Phone

(248) 849-8816

NPI assigned

Aug 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1447928197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 AUDUBON DR",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924306",
            "telephone_number": "313-806-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDRZEJCZYK",
        "first_name": "BEATA",
        "name_prefix": "Ms.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851106927",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851106927",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6851106927",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena N Jdanova, M.D.
• Phoebee Jean
• Jeanette's Home LLC
• Julian Jeberaeel
• Jeci Medical Supply Inc.
• Jeevaka Yapa DDS PC (New Center Oral & Maxillofacial Surgery)
• Tomyia M Jefferson
• Jeffrey M Last PHD PLLC
• Jeffrey T Najor MD PLLC
• Tamika Jeffries

• Social Worker in Southfield, MI
• Providers in Southfield, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.