Individual provider Active NPI

Terry Lee Dunivin, MSW

  • Mental Health Counselor
  • Ann Arbor, MI
National Provider Identifier
1629184510
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801016469 Issued in MI
Practice address
5331 Plymouth Rd
Ann Arbor, MI 48105-9520
Phone
(734) 996-9111
Fax
(734) 996-1950
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801016469 MI Primary

Addresses

Primary practice location

5331 Plymouth Rd
Ann Arbor, MI 48105-9520

Mailing address

5331 Plymouth Rd
Ann Arbor, MI 48105-9520
Phone (734) 996-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911001847 MI Practitioner - Clinical Social Worker 5395741961 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801016469MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
RMJ1 Social Worker CurrentSince Jun 5, 2019 Accepting new patients

Locations

5331 Plymouth Rd
Ann Arbor, MI 48105
Phone (734) 412-7300

2200 Green Rd
Ste M
Ann Arbor, MI 48105
Phone (734) 412-7300

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629184510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059520",
            "telephone_number": "734-996-9111",
            "fax_number": "734-996-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059520",
            "telephone_number": "734-996-9111",
            "fax_number": "734-996-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNIVIN",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801016469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.