Individual provider Active NPI

Theresa Taylor

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1518362029
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097349 Issued in MI
Practice address
22170 W 9 Mile Rd
Southfield, MI 48033-6007
Phone
(248) 485-8609
NPI assigned
Oct 27, 2014
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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 6801097349 MI Primary

Addresses

Primary practice location

22170 W 9 Mile Rd
Southfield, MI 48033-6007

Mailing address

615 East St
Milford, MI 48381-1638

Other practice location 1

8623 N Wayne Rd
Suite 200
Westland, MI 48185-1137
Phone (734) 458-4601

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcerecords.essmichigan@direct.mihin.net Easterseals MORC Health Care, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • 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
I20171031001940 MI Practitioner - Clinical Social Worker 3577839877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.79 of 100Reported as group
Quality
90.17
Promoting interoperability
83
Improvement activities
40
Cost
86.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. CurrentSince Sep 13, 2017 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1518362029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 EAST ST",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483811638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-485-8609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8623 N Wayne Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481851137",
            "country_code": "US",
            "telephone_number": "734-458-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easterseals MORC Health Care, Inc.",
            "address_1": "2399 E Walton Blvd",
            "city": "Auburn Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483261955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.