Vickie McTaw, CAC-M

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Practice address

2409 Calvert St
Detroit, MI 48206-1533

Phone

(313) 869-6905

NPI assigned

Jan 22, 2010

Sex

Female

Sole proprietor

Yes

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

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.

• Guiding Light Sober Living

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
  • NPI 1679803464
  NPD (past)

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669703146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35390 VAN BORN RD APT 303",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481843317",
            "telephone_number": "734-934-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CALVERT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061533",
            "telephone_number": "313-869-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCTAW",
        "first_name": "VICKIE",
        "name_prefix": "Ms.",
        "credential": "CAC-M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda McRae, MA LLPC
• Jermaine McReynolds
• Sherry Ellen McRill, MA.,LLP
• Asia Shawnisa McSpadden
• Almond McSwain
• Deborah Michelle McTyre, MSW
• Katherine Anne McVety, M.D.
• David W. McVinnie, M.D.
• Nora Marie McVinnie, MD
• Deborah McWilliams, RN, CPNP

• Mental Illness Community Based Residential Treatment Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Mental Illness Community Based Residential Treatment Facility 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.