Tamara June Antishin, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801094544 Issued in MI

Practice address

888 W Big Beaver Rd Ste 780
Troy, MI 48084-4745

Phone

(248) 270-5660

NPI assigned

Apr 1, 2013

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Training & Treatment Innovations Inc

  • Community/Behavioral Health Agency
  • Oxford, MI
  • NPI 1609857978
  Medicare reassignment NPD
• Training and Treatment Innovations Inc

  • Public Health or Welfare Agency
  • Sterling Heights, MI
  • NPI 1295084721
  NPD
• Consumer Services, Inc.

  dba Taylor Life Center

  • Adult Mental Health Clinic/Center
  • Mason, MI
  • NPI 1306876735
  NPD (past)

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1720321458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD STE 780",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844745",
            "telephone_number": "248-270-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD STE 780",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844745",
            "telephone_number": "248-270-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTISHIN",
        "first_name": "TAMARA",
        "middle_name": "JUNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094544",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ansari Dental of Troy PLLC
• Omar Ansari, DDS
• Kristin Colleen Ansel, LPC
• Amanda Rae Antczak, PA-C
• Anthony Vincent Potts OD PC
• Anita Lucia Antoniolli, MD
• Jamie Nkechiyere Anumba, FNP-BC
• Fadi Murad Anwar, PT, DPT
• Ao of Troy PLLC (My Forever Smile Troy)
• Apex Real Estate Holdings LLC

• Social Worker in Troy, MI
• Providers in Troy, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.