Individual provider Active NPI

Victoria Waites, LLMSW

  • Clinical Social Worker
  • Saginaw, MI
National Provider Identifier
1689311540
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851114800 Issued in MI
Practice address
3253 Congress Ave
Saginaw, MI 48602-3106
Phone
(989) 475-4171
Fax
(989) 393-6021
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851114800 MI Primary

Addresses

Primary practice location

3253 Congress Ave
Saginaw, MI 48602-3106

Mailing address

3253 Congress Ave
Saginaw, MI 48602-3106
Phone (989) 475-4171

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851114800MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1689311540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3253 CONGRESS AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023106",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3253 CONGRESS AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023106",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITES",
        "first_name": "VICTORIA",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851114800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.