Individual provider Active NPI

Rogjett Peterson, MSW, LLMSW

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1639832330
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851115752 Issued in MI
Practice address
17320 W 12 Mile Rd
Southfield, MI 48076-2100
Phone
(248) 494-8076
NPI assigned
Oct 19, 2021
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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 6851115752 MI Primary

Addresses

Primary practice location

17320 W 12 Mile Rd
Southfield, MI 48076-2100

Mailing address

6549 Town Center Dr Ste a
Clarkston, MI 48346-4824
Phone (626) 494-4968

Other practice location 1

32961 Middlebelt Rd
Farmington Hills, MI 48334-1729
Phone (800) 395-3223

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851115752MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1639832330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "626-494-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17320 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762100",
            "telephone_number": "248-494-8076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32961 Middlebelt Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483341729",
            "country_code": "US",
            "telephone_number": "800-395-3223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ROGJETT",
        "name_prefix": "Ms.",
        "credential": "MSW, LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851115752",
            "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 Feb 10, 2023; 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.