Active NPI
Daniellie Jordan
- Social Worker
- Warren, MI
National Provider Identifier
1588030357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6851099084
- Practice address
- 8143 Vermont Ave # 320
Warren, MI 48093-7217 - Phone
- (313) 575-3634
- NPI assigned
- Aug 17, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6851099084 | MI | Primary |
Addresses
Primary practice location
8143 Vermont Ave # 320
Warren, MI 48093-7217
Mailing address
8143 Vermont Ave
Warren, MI 48093-7217
Phone (313) 575-3634
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851099084 | MI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | 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 and National Provider Directory roles.
-
dba Great Lakes Psychology Group
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1588030357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8143 VERMONT AVE",
"city": "WARREN",
"state": "MI",
"postal_code": "480937217",
"telephone_number": "313-575-3634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8143 VERMONT AVE # 320",
"city": "WARREN",
"state": "MI",
"postal_code": "480937217",
"telephone_number": "313-575-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "DANIELLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-17",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6851099084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.