Individual provider Active NPI

Neoshua Butler

  • Clinical Social Worker
  • Ferndale, MI
National Provider Identifier
1699289918
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
800 Hilton Rd
Ferndale, MI 48220-2505
Phone
(248) 238-8074
Fax
(248) 665-8685
NPI assigned
Nov 22, 2017
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary
School Social Worker 1041S0200X MI
Behavior Technician 106S00000X NU

Addresses

Primary practice location

800 Hilton Rd
Ferndale, MI 48220-2505

Mailing address

17619 Steel St
Detroit, MI 48235-1447
Phone (248) 238-8074

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
I20230703001636 MI Practitioner - Clinical Social Worker 5395104798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29800 Harper Ave
Saint Clair Shores, MI 48082-1655
Phone (248) 417-0248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Opening New Doors LLC Clinical CurrentSince May 1, 2023 Accepting new patients

Locations

800 Hilton Rd
Ste 5
Ferndale, MI 48220
Phone (248) 238-8074

29800 Harper Ave
Saint Clair Shores, MI 48082
Phone (248) 410-4797

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1699289918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17619 STEEL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351447",
            "telephone_number": "248-238-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HILTON RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202505",
            "telephone_number": "248-238-8074",
            "fax_number": "248-665-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "NEOSHUA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.