Individual provider Active NPI

Angela Renee Maritim-Brooks, LMSW

  • Clinical Social Worker
  • Roseville, MI
National Provider Identifier
1467486001
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801072407 Issued in MI
Practice address
18600 Florence St Ste T7
Roseville, MI 48066
Phone
(586) 552-4811
Fax
(586) 552-4822
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801072407 MI Primary

Addresses

Primary practice location

18600 Florence St Ste T7
Roseville, MI 48066

Mailing address

18600 Florence St Ste T7
Roseville, MI 48066-4862
Phone (586) 552-4811

Other names 1

  • Angela Renee Maritim Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060124000787 MI Practitioner - Clinical Social Worker 7214951466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18600 Florence St
Suite 7
Roseville, MI 48066-6600
Phone (586) 552-4811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Soka Services Clinical Past Accepting new patients
Une Sur Une Resource Services LLC Clinical Past Accepting new patients
Glory Counseling Services Clinical PastSince May 4, 2009 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1467486001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18600 FLORENCE ST STE T7",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664862",
            "telephone_number": "586-552-4811",
            "fax_number": "586-552-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18600 FLORENCE ST STE T7",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "48066",
            "telephone_number": "586-552-4811",
            "fax_number": "586-552-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARITIM-BROOKS",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801072407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MARITIM",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.