Sandra Stevenson Maddock, MSS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801077150 Issued in MI

Practice address

410 West University
Rochester, MI 48307-1938

Phone

(248) 608-1482

Fax

(248) 652-9930

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699812206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 WEST UNIVERSITY",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071938",
            "telephone_number": "248-608-1482",
            "fax_number": "248-652-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 WEST UNIVERSITY",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071938",
            "telephone_number": "248-608-1482",
            "fax_number": "248-652-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOCK",
        "first_name": "SANDRA",
        "middle_name": "STEVENSON",
        "name_prefix": "Mrs.",
        "credential": "MSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077150",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "0000227",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Rochester, MI
• Providers in Rochester, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.