Individual provider Active NPI

Corrine Lynn Holden, LLMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1588960686
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092325 Issued in MI
Practice address
10 Peterboro St
Detroit, MI 48201-2722
Phone
(313) 831-3160
Fax
(313) 831-2604
NPI assigned
Feb 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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 6801092325 MI Primary

Addresses

Primary practice location

10 Peterboro St
Detroit, MI 48201-2722

Mailing address

17133 Rivergreen Blvd
Apt# 304
Riverview, MI 48193-8060
Phone (313) 408-2182

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

State licenses

LicenseStateTypeSpecialty
6801092325MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1588960686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17133 RIVERGREEN BLVD",
            "address_2": "APT# 304",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481938060",
            "telephone_number": "313-408-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PETERBORO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012722",
            "telephone_number": "313-831-3160",
            "fax_number": "313-831-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "CORRINE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092325",
            "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 Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.