Active NPI
Adult & Family Services
- Clinical Social Worker
- Southgate, MI
National Provider Identifier
1720130461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801060222
- Legal business name
- ADULT & FAMILY SERVICES
- Practice address
- 19291 Northline Rd
Southgate, MI 48195-2220 - Phone
- (734) 287-1500
- NPI assigned
- Jan 16, 2007
- 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
- Mr. Mark Small, MSW
- Title
- Supervisor
- Phone
- (734) 287-1500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 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
National Provider Directory
National Provider Directory- Tax ID family
- Adult Family Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Detroit, MI
- NPI 1235212572
Locations
19291 Northline Rd
Southgate, MI 48195
Phone (734) 287-1500
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.