Organization Active NPI

Safe With Self BHTC

  • Social Worker
  • Flint, MI
National Provider Identifier
1699518795
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
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

Updated by the provider on Jun 17, 2024

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)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Former legal business name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.