Active NPI
Jay Lynn Devereaux, LMSW
- Clinical Social Worker
- Dearborn, MI
National Provider Identifier
1487993408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801067855
- Practice address
- 19855 Outer Dr Ste 104
Dearborn, MI 48124-2022 - Phone
- (313) 274-5840
- NPI assigned
- Feb 12, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 6801067855 | MI | Primary |
Addresses
Primary practice location
19855 Outer Dr Ste 104
Dearborn, MI 48124-2022
Mailing address
26722 Clairview Dr
Dearborn Heights, MI 48127-1644
Phone (734) 306-9392
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801067855 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360627200000",
"number": "1487993408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26722 CLAIRVIEW DR",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481271644",
"telephone_number": "734-306-9392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19855 OUTER DR STE 104",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-274-5840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVEREAUX",
"first_name": "JAY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-12",
"last_updated": "2013-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801067855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.