Individual provider Active NPI

Petrina Grace Biondo, MSW

  • Clinical Social Worker
  • West Bloomfield, MI
National Provider Identifier
1710050679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801046621 Issued in MI
Practice address
2472 Empire Dr
West Bloomfield, MI 48324-1733
Phone
(248) 481-9209
Fax
(248) 481-9208
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801046621 MI Primary

Addresses

Primary practice location

2472 Empire Dr
West Bloomfield, MI 48324-1733

Mailing address

2472 Empire Dr
West Bloomfield, MI 48324-1733
Phone (248) 481-9209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801046621MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Community Living, Inc. PastSince Sep 24, 2023 Accepting new patients

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710050679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 EMPIRE DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483241733",
            "telephone_number": "248-481-9209",
            "fax_number": "248-481-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2472 EMPIRE DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483241733",
            "telephone_number": "248-481-9209",
            "fax_number": "248-481-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIONDO",
        "first_name": "PETRINA",
        "middle_name": "GRACE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801046621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • 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.