Active NPI
Benetta A Davis, BA LBSW
- Social Worker
- Southgate, MI
National Provider Identifier
1508956525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802082868
- Practice address
- 19401 Northline Rd. BLGD. 5
The Guidance Center
Southgate, MI 48195 - Phone
- (734) 785-7718
- NPI assigned
- Oct 13, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802082868 | MI | Primary |
Addresses
Primary practice location
19401 Northline Rd. BLGD. 5
The Guidance Center
Southgate, MI 48195
Mailing address
1669 Savannah CT
Superior TWP, MI 48198-3681
Phone (734) 444-7591
Other names 1
- Benetta Johnson
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802082868 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1508956525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1669 SAVANNAH CT",
"city": "SUPERIOR TWP",
"state": "MI",
"postal_code": "481983681",
"telephone_number": "734-444-7591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19401 NORTHLINE RD. BLGD. 5",
"address_2": "THE GUIDANCE CENTER",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "48195",
"telephone_number": "734-785-7718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BENETTA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "BA LBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802082868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BENETTA",
"last_name": "JOHNSON",
"credential": "BA LBSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.