Active NPI
Combined Success
- Community Health Worker
- Southfield, MI
National Provider Identifier
1457948598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Legal business name
- COMBINED SUCCESS
- Practice address
- 18620 W 10 Mile Rd
Southfield, MI 48075-2667 - Phone
- (248) 763-0801
- NPI assigned
- Dec 23, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Ida Veronica Colquitt, MA, LLP
- Title
- Therapist
- Phone
- (248) 763-0801
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Social Worker | 104100000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
18620 W 10 Mile Rd
Southfield, MI 48075-2667
Mailing address
20690 Wayland St
Southfield, MI 48076-5666
Phone (248) 763-0801
National Provider Directory
National Provider DirectoryLocations
18620 W 10 Mile Rd
Southfield, MI 48075
Phone (248) 763-0801
Practitioners & affiliated clinicians
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.
-
- Psychologist
- Highland Park, MI
- NPI 1528209590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608681600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1608681600000",
"number": "1457948598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20690 WAYLAND ST",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480765666",
"telephone_number": "248-763-0801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18620 W 10 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752667",
"telephone_number": "248-763-0801"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMBINED SUCCESS",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-23",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A",
"authorized_official_last_name": "COLQUITT",
"authorized_official_first_name": "IDA",
"authorized_official_middle_name": "VERONICA",
"authorized_official_title_or_position": "THERAPIST",
"authorized_official_telephone_number": "248-763-0801",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MA, LLP"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.