Richard Mills Nielsen III

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6802079952 Issued in MI

Practice address

12800 E Warren Ave
Detroit, MI 48215-2061

Phone

(313) 824-8000

Fax

(313) 824-5589

NPI assigned

Mar 9, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Richard Mills Nielsen III Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1669770061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "313-824-8000",
            "fax_number": "313-824-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "313-824-8000",
            "fax_number": "313-824-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "RICHARD",
        "middle_name": "MILLS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802079952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6802079952",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "NIELSEN",
            "middle_name": "MILLS",
            "prefix": "MR.",
            "suffix": "III",
            "credential": "LBSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brian Philip Niebuhr
• Bruce Niebylski, M.D.
• Niecys Transitional Housing and Personal Care Services
• Marilyn Niedermeier, MD
• Keltie H Nielsen, LPC
• Mallory Nicole Niemczyk
• Sarah Rose Niemiec
• Elizabeth Nienhuis
• Krystyn Niescier, LMSW
• Lisa Nieves

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.