Individual provider Active NPI

Emily Fitzgerald, LMSW

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1497156871
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096810 Issued in MI
Practice address
705 S Main St
Suite 280
Plymouth, MI 48170-2089
Phone
(734) 454-3560
Fax
(734) 454-3570
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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 6801096810 MI Primary

Addresses

Primary practice location

705 S Main St
Suite 280
Plymouth, MI 48170-2089

Mailing address

3694 Clarkston Rd
Suite D
Clarkston, MI 48348-5213
Phone (248) 693-8880

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

LicenseStateTypeSpecialty
6801096810MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1497156871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3694 CLARKSTON RD",
            "address_2": "SUITE D",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485213",
            "telephone_number": "248-693-8880",
            "fax_number": "248-391-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S MAIN ST",
            "address_2": "SUITE 280",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702089",
            "telephone_number": "734-454-3560",
            "fax_number": "734-454-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "EMILY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.