Active NPI
Wayne White
- Social Worker
- Detroit, MI
National Provider Identifier
1730545260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802088435
- Practice address
- 24424 W McNichols Rd
Detroit, MI 48219-3653 - Phone
- (313) 255-0900
- NPI assigned
- Jan 13, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Social Worker | 104100000X | 6802088435 | MI | Primary |
Addresses
Primary practice location
24424 W McNichols Rd
Detroit, MI 48219-3653
Mailing address
125 Aberdeen LN
Monroe, MI 48161-9090
Phone (734) 755-6846
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6802088435 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1730545260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 ABERDEEN LN",
"city": "MONROE",
"state": "MI",
"postal_code": "481619090",
"telephone_number": "734-755-6846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24424 W MCNICHOLS RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482193653",
"telephone_number": "313-255-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "WAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-13",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802088435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.