Individual provider Active NPI

Yolanda Carpenter

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1699168948
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801111238 Issued in MI
Practice address
16210 Schoolcraft St
Detroit, MI 48227-1739
Phone
(313) 752-4887
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801111238 MI
Clinical Social Worker 1041C0700X 6801111238 MI Primary

Addresses

Primary practice location

16210 Schoolcraft St
Detroit, MI 48227-1739

Mailing address

28870 Monterey Dr
Southfield, MI 48076-2369
Phone (248) 977-2794

Other practice location 1

28870 Monterey Dr
Southfield, MI 48076-2369
Phone (248) 977-2794

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
I20221020003092 MI Practitioner - Clinical Social Worker 4789050485 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801111238MIMDClinical Social Worker

Organizations & group practices 1

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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1699168948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28870 MONTEREY DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762369",
            "telephone_number": "248-977-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16210 SCHOOLCRAFT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271739",
            "telephone_number": "313-752-4887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28870 Monterey Dr",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480762369",
            "country_code": "US",
            "telephone_number": "248-977-2794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "YOLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801111238",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801111238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.