Individual provider Active NPI

Ivy Jeanette-Martin Whinsett

  • Clinical Social Worker
  • Mount Clemens, MI
National Provider Identifier
1508199837
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087176 Issued in MI
Practice address
117 Cass Ave
Suite 302
Mount Clemens, MI 48043-2252
Phone
(586) 495-5120
NPI assigned
Sep 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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 6801087176 MI Primary

Addresses

Primary practice location

117 Cass Ave
Suite 302
Mount Clemens, MI 48043-2252

Mailing address

22393 Beechwood Ave
Eastpointe, MI 48021-2105

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
6801087176MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Counseling P.C. Clinical Past Accepting new patients

Organizations & group practices 1

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": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1508199837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22393 BEECHWOOD AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CASS AVE",
            "address_2": "SUITE 302",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432252",
            "telephone_number": "586-495-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHINSETT",
        "first_name": "IVY",
        "middle_name": "JEANETTE-MARTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.