Individual provider Active NPI

Carri Rene Griffin, LMSW

  • Clinical Social Worker
  • Oak Park, MI
National Provider Identifier
1720695091
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801082007 Issued in MI
Practice address
23221 Republic Ave
Oak Park, MI 48237-2355
Phone
(586) 668-6751
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 6801082007 MI
Clinical Social Worker 1041C0700X 6801082007 MI Primary

Addresses

Primary practice location

23221 Republic Ave
Oak Park, MI 48237-2355

Mailing address

23221 Republic Ave
Oak Park, MI 48237-2355
Phone (586) 668-6751

Other names 1

  • Carri Rene Lutt Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801082007MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1720695091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23221 REPUBLIC AVE",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372355",
            "telephone_number": "586-668-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23221 REPUBLIC AVE",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372355",
            "telephone_number": "586-668-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CARRI",
        "middle_name": "RENE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "6801082007",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801082007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRI",
            "last_name": "LUTT",
            "middle_name": "RENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.