Mario Tatum

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802087475 Issued in MI

Practice address

3946 Cadieux Rd
Detroit, MI 48224-4010

Phone

(734) 778-4055

NPI assigned

Aug 24, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Health & Wellness Community Services LLC

  • Case Management Agency
  • Detroit, MI
  • NPI 1558876987
  NPD Authorized official

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629595350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3946 CADIEUX",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48224",
            "telephone_number": "734-778-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 CADIEUX RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482244010",
            "telephone_number": "734-778-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "MARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802087475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyona Tate, LLMSW
• Nicole Marie Tate, CNA
• Nutrena Tate, CNP
• Shana Tate
• Geneva Beatrice Tatem, M.D.
• Taesha Tatum
• Therrian Tatum
• Valerie Winston Tatum, R.D.
• Jeffrey W. Taub, M.D.
• Anam Taufiq

• Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.