Active NPI
Manisha Leary
- Clinical Social Worker
- Detroit, MI
National Provider Identifier
1568822963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801092047
- Practice address
- 3901 Chrysler Service Dr
Detroit, MI 48201-2167 - Phone
- (313) 993-3434
- Fax
- (313) 993-3421
- NPI assigned
- Feb 26, 2016
- Last updated
- Nov 16, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801092047 | MI | Primary |
Addresses
Primary practice location
3901 Chrysler Service Dr
Detroit, MI 48201-2167
Mailing address
400 Mack Ave.
Credentialing Dept.
Detroit, MI 48201-1138
Phone (313) 448-9006
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Group | Social Worker | Past | Accepting new patients |
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.
-
dba Wayne State University Physician Group
- Counselor
- Detroit, MI
- NPI 1447465661
Social Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1568822963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 MACK AVE.",
"address_2": "CREDENTIALING DEPT.",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011138",
"telephone_number": "313-448-9006",
"fax_number": "313-993-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 CHRYSLER SERVICE DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012167",
"telephone_number": "313-993-3434",
"fax_number": "313-993-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEARY",
"first_name": "MANISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-26",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801092047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.