Individual provider Active NPI

Kenitra L. Webster, LMSW

  • Clinical Social Worker
  • Brighton, MI
National Provider Identifier
1538914692
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801108243 Issued in MI
Practice address
2200 Genoa Business Park Dr
Brighton, MI 48114-5328
Phone
(517) 882-3732
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 6801108243 MI Primary

Addresses

Primary practice location

2200 Genoa Business Park Dr
Brighton, MI 48114-5328

Mailing address

2200 Genoa Business Park Dr
Brighton, MI 48114-5328
Phone (517) 882-3732

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
I20240504000311 MI Practitioner - Clinical Social Worker 1456791615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801108243MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Apr 30, 2024 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Apr 30, 2024 Accepting new patients

Locations

2350 Green Rd
Ste 160
Ann Arbor, MI 48105
Phone (315) 771-4657

2350 Green Rd
Ste 150160
Ann Arbor, MI 48105
Phone (734) 285-8282

2200 Genoa Business Park Dr
Ste 100
Brighton, MI 48114
Phone (810) 449-7180

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

Organizations & group practices 2

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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1538914692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GENOA BUSINESS PARK DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481145328",
            "telephone_number": "517-882-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GENOA BUSINESS PARK DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481145328",
            "telephone_number": "517-882-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "KENITRA",
        "middle_name": "L.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.