Active NPI
Lidija M Nikolovska, LMSW CSW
- Social Worker
- Grosse, MI
National Provider Identifier
1679583298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801067735
- Practice address
- 8021 Burning Bush Grosse Ile,Mi 48138
Grosse, MI 48138 - Phone
- (248) 245-1130
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801067735 | MI | |
| Social Worker | 104100000X | 6801067735 | MI | Primary |
Addresses
Primary practice location
8021 Burning Bush Grosse Ile,Mi 48138
Grosse, MI 48138
Mailing address
19598 Kathron CR
Grosse Ile, MI 48138
Phone (248) 245-1130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8008974190 | Other | MI | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801067735 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1679583298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19598 KATHRON CR",
"city": "GROSSE ILE",
"state": "MI",
"postal_code": "48138",
"telephone_number": "248-245-1130",
"fax_number": "734-642-3424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8021 BURNING BUSH GROSSE ILE,MI 48138",
"city": "GROSSE",
"state": "MI",
"postal_code": "48138",
"telephone_number": "248-245-1130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIKOLOVSKA",
"first_name": "LIDIJA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LMSW CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2024-12-05",
"certification_date": "2024-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801067735",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801067735",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8008974190",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.