Individual provider Active NPI

Maryam J Jundi

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1619895646
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
J530585031404 Issued in MI
Practice address
29600 Northwestern Hwy
Southfield, MI 48034-1016
Phone
(248) 838-3390
NPI assigned
Jul 7, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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 J530585031404 MI Primary

Addresses

Primary practice location

29600 Northwestern Hwy
Southfield, MI 48034-1016

Mailing address

7542 Greenway LN
West Bloomfield, MI 48324-4796
Phone (248) 937-0167

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": "1783382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1619895646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7542 GREENWAY LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483244796",
            "telephone_number": "248-937-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29600 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341016",
            "telephone_number": "248-838-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNDI",
        "first_name": "MARYAM",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-07-07",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "J530585031404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.