Active NPI
Jasmine Charles
- Clinical Social Worker
- Southgate, MI
National Provider Identifier
1548645351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 14799 Dix Toledo Rd
Southgate, MI 48195-2507 - Phone
- (734) 324-8326
- NPI assigned
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Mailing address
32555 Birchwood St
Westland, MI 48186-7903
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669451944 | Medicaid | MI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464307200000",
"number": "1548645351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32555 BIRCHWOOD ST",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481867903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14799 DIX TOLEDO RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952507",
"telephone_number": "734-324-8326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "JASMINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-22",
"last_updated": "2016-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669451944",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}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 May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.