Individual provider Active NPI

Marie Annette Fox, LMSW

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1659428258
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801083185 Issued in MI
Practice address
2265 Livernois Rd Ste 260
Troy, MI 48083-1639
Phone
(248) 906-0794
Fax
(866) 656-1713
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 6801083185 MI Primary

Addresses

Primary practice location

2265 Livernois Rd Ste 260
Troy, MI 48083-1639

Mailing address

29696 Spoon Ave
Madison Heights, MI 48071-4437
Phone (985) 688-0208

Other identifiers 1

IdentifierTypeStateIssuer
MI2165004OtherPTAN OR LEGACY NUMBER

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
I20040525000896 MI Practitioner - Clinical Social Worker 7113908328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2265 Livernois Rd
Suite 260
Troy, MI 48083-1639
Phone (985) 688-0208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801083185MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Moksa Yoga Therapy, LLC Clinical CurrentSince Oct 13, 2010 Accepting new patients
Henry Ford Health Eastwood Behavioral Health CurrentSince Apr 15, 2018 Accepting new patients

Locations

17250 Farmington Rd
Livonia, MI 48152
Phone (734) 425-4070

2265 Livernois Rd
Ste 260
Troy, MI 48083
Phone (248) 990-6959

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Organizations & group practices 2

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1659428258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29696 SPOON AVE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480714437",
            "telephone_number": "985-688-0208",
            "fax_number": "866-656-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 LIVERNOIS RD STE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831639",
            "telephone_number": "248-906-0794",
            "fax_number": "866-656-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "MARIE",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801083185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN OR LEGACY NUMBER",
            "identifier": "MI2165004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.