Individual provider Active NPI

Leon Thomas Charette

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1689840936
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801080606 Issued in MI
Practice address
2925 Russell St
Detroit, MI 48207-4825
Phone
(226) 347-1520
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 6801080606 MI Primary

Addresses

Primary practice location

2925 Russell St
Detroit, MI 48207-4825

Mailing address

2925 Russell St
Detroit, MI 48207-4825
Phone (226) 347-1520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005002983 MI Practitioner - Clinical Social Worker 8325313042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Team Mental Health Services IncGroup PAC ID 2264451830, 33 clinicians

Practice addresses (Care Compare)

2925 Russell St
Detroit, MI 48207-4825
Phone (313) 396-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801080606MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Team Mental Health Services Inc. CurrentSince Jul 23, 2024 Accepting new patients
Team Wellness Center CurrentSince Jul 23, 2024 Accepting new patients
Adult Well-Being Services Past Accepting new patients

Locations

290 Town Center Dr
Ste 400
Dearborn, MI 48126
Phone (248) 763-5289

2925 Russell St
Detroit, MI 48207
Phone (313) 462-4714

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1689840936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 RUSSELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074825",
            "telephone_number": "226-347-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RUSSELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074825",
            "telephone_number": "226-347-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARETTE",
        "first_name": "LEON",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801080606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.