Individual provider Active NPI

Mary Louise Cunniffe, MSW

  • Social Worker
  • Detroit, MI
National Provider Identifier
1518389147
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801092682 Issued in MI
Practice address
882 Oakman Blvd
Suite D
Detroit, MI 48238-3710
Phone
(313) 691-7990
NPI assigned
Jan 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801092682 MI
Social Worker 104100000X 6801092682 MP
Clinical Social Worker 1041C0700X 6801092682 MI
Social Worker 104100000X 6801092682 MI Primary

Addresses

Primary practice location

882 Oakman Blvd
Suite D
Detroit, MI 48238-3710

Mailing address

120 Campbell St
#8
Rochester, MI 48307-2677
Phone (248) 238-5033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • 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
I20160526000778 MI Practitioner - Clinical Social Worker 6204126642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

41700 Gardenbrook Rd
Suite 110
Novi, MI 48375-1320
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092682MPMDSocial Worker
6801092682MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Sep 12, 2022 Accepting new patients

Locations

41700 Gardenbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 429-7309

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

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": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1518389147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CAMPBELL ST",
            "address_2": "#8",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072677",
            "telephone_number": "248-238-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 OAKMAN BLVD",
            "address_2": "SUITE D",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383710",
            "telephone_number": "313-691-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNIFFE",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2023-04-25",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801092682",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MP",
            "license": "6801092682",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092682",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801092682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.