Individual provider Active NPI

Beth Lanette Baker Callen, LMSW

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1740391135
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087468 Issued in MI
Practice address
18444 W 10 Mile Rd Ste 200
Southfield, MI 48075-2626
Phone
(248) 702-4145
NPI assigned
Aug 31, 2006
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801087468 MI Primary

Addresses

Primary practice location

18444 W 10 Mile Rd Ste 200
Southfield, MI 48075-2626

Mailing address

19785 W 12 Mile Rd
PMB 553
Southfield, MI 48076-2584
Phone (248) 702-4145

Other practice location 1

4646 John R St
553-11 MH-HP
Detroit, MI 48201-1916
Phone (313) 576-1000 ext. 64930

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
I20131211001484 MI Practitioner - Clinical Social Worker 1658508924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801087468MIMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1740391135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19785 W 12 MILE RD",
            "address_2": "PMB 553",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762584",
            "telephone_number": "248-702-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18444 W 10 MILE RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752626",
            "telephone_number": "248-702-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 John R St",
            "address_2": "553-11 MH-HP",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482011916",
            "country_code": "US",
            "telephone_number": "313-576-1000 x64930",
            "fax_number": "313-576-1074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER CALLEN",
        "first_name": "BETH",
        "middle_name": "LANETTE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.