NPIMap

Organization Active NPI

Adult & Family Services

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1720130461
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801060222 Issued in MI
Legal business name
ADULT & FAMILY SERVICES
Practice address
19291 Northline Rd
Southgate, MI 48195-2220
Phone
(734) 287-1500
NPI assigned
Jan 16, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Mr. Mark Small, MSWNPI 1649430653
Title
Supervisor
Phone
(734) 287-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801060222 MI Primary

Addresses

Primary practice location

19291 Northline Rd
Southgate, MI 48195-2220

Mailing address

19291 Northline Rd
Southgate, MI 48195-2220
Phone (734) 287-1500

Other names 1

  • The Guidance Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Adult Family Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1720130461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19291 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952220",
            "telephone_number": "734-287-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19291 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952220",
            "telephone_number": "734-287-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "734-287-1500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801060222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Guidance Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.