Individual provider Active NPI

Kelly Leann Lovorn

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1457979239
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851110812 Issued in MI
Practice address
31557 Schoolcraft Rd Ste 200
Livonia, MI 48150-1848
Phone
(734) 474-2958
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X 6851110812 MI Primary

Addresses

Primary practice location

31557 Schoolcraft Rd Ste 200
Livonia, MI 48150-1848

Mailing address

350 N Main St Ste 220
Chelsea, MI 48118-1635
Phone (734) 433-5100

Other practice location 1

350 N Main St Ste 220
Chelsea, MI 48118-1635
Phone (734) 433-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851110812MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1457979239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N MAIN ST STE 220",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181635",
            "telephone_number": "734-433-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31557 SCHOOLCRAFT RD STE 200",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501848",
            "telephone_number": "734-474-2958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Main St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MI",
            "postal_code": "481181635",
            "country_code": "US",
            "telephone_number": "734-433-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVORN",
        "first_name": "KELLY",
        "middle_name": "LEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851110812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.