Active NPI
Safe With Self BHTC
- Social Worker
- Flint, MI
National Provider Identifier
1699518795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Legal business name
- SAFE WITH SELF BHTC
- Practice address
- 2109 Martin Luther King Ave
Flint, MI 48503-1027 - Phone
- (810) 335-4366
- NPI assigned
- Jun 17, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hossam Shukairy
- Title
- Credentialin
- Phone
- (810) 780-4181
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary | ||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
2109 Martin Luther King Ave
Flint, MI 48503-1027
Mailing address
329 Leta Ave
Flint, MI 48507-2727
Phone (810) 335-4366
Other names 1
- SAFE WITH SELF BHTC
National Provider Directory
National Provider DirectoryLocations
2109 Martin Luther King Ave
Flint, MI 48503
Phone (810) 335-4366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718582400000",
"number": "1699518795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 LETA AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485072727",
"telephone_number": "810-335-4366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 MARTIN LUTHER KING AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485031027",
"telephone_number": "810-335-4366"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFE WITH SELF BHTC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A",
"authorized_official_last_name": "SHUKAIRY",
"authorized_official_first_name": "HOSSAM",
"authorized_official_title_or_position": "CREDENTIALIN",
"authorized_official_telephone_number": "810-780-4181"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SAFE WITH SELF BHTC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.