Individual provider Active NPI

Daniel T Desena, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1720300890
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088854 Issued in MI
Practice address
2002 Hogback Rd Ste 10
Ann Arbor, MI 48105-9736
Phone
(734) 368-7819
NPI assigned
Feb 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801088854 MI
Clinical Social Worker 1041C0700X 6801088854 MI Primary

Addresses

Primary practice location

2002 Hogback Rd Ste 10
Ann Arbor, MI 48105-9736

Mailing address

2002 Hogback Rd Ste 10
Ann Arbor, MI 48105-9736
Phone (734) 368-7819

Other practice location 1

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118
Phone (734) 995-5181

Other identifiers 1

IdentifierTypeStateIssuer
8008992490OtherMIBCBS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317001027 MI Practitioner - Clinical Social Worker 3375678212 Practice locations: East Lansing, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1690 Watertower Place
Suite 100 356
East Lansing, MI 48823-8045
Phone (734) 368-7819

2002 Hogback Rd
Suite 10
Ann Arbor, MI 48105-9736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088854MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel T Desena, LMSW, PLLC Current Accepting new patients

Locations

2002 Hogback Rd
Ste 10
Ann Arbor, MI 48105
Phone (734) 353-9019

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": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1720300890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 HOGBACK RD STE 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059736",
            "telephone_number": "734-368-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HOGBACK RD STE 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059736",
            "telephone_number": "734-368-7819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2395 Oak Valley Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481039118",
            "country_code": "US",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESENA",
        "first_name": "DANIEL",
        "middle_name": "T",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801088854",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "8008992490",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.