Organization Active NPI

Dina Baldwin Berdy LLC

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1689046732
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801084378 Issued in MI
Legal business name
DINA BALDWIN BERDY LLC
Practice address
575 E Big Beaver Rd
Suite 260
Troy, MI 48083-1300
Phone
(248) 561-6875
NPI assigned
Oct 28, 2015
Last updated
Oct 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Ms. Dina Baldwin Berdy, LMSW
Title
Social Worker
Phone
(248) 561-6875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801084378 MI Primary

Addresses

Primary practice location

575 E Big Beaver Rd
Suite 260
Troy, MI 48083-1300

Mailing address

575 E Big Beaver Rd
Suite 260
Troy, MI 48083-1300
Phone (248) 561-6875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151208002600 MI Part B Supplier - Clinic/Group Practice 0749581130 Practice locations: Huntington Woods, MI

National Provider Directory

National Provider Directory

Locations

26789 Woodward Ave
Ste 208
Huntington Woods, MI 48070
Phone (248) 514-5187

575 E Big Beaver Rd
Ste 260
Troy, MI 48083
Phone (248) 515-8873

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1689046732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E BIG BEAVER RD",
            "address_2": "SUITE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831300",
            "telephone_number": "248-561-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E BIG BEAVER RD",
            "address_2": "SUITE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831300",
            "telephone_number": "248-561-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DINA BALDWIN BERDY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "BERDY",
        "authorized_official_first_name": "DINA",
        "authorized_official_middle_name": "BALDWIN",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "248-561-6875",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801084378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.