Active NPI
Debra Gayle Hendren, LICENSED BACHELOR'S
- Social Worker
- Troy, MI
National Provider Identifier
1740771872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802076082
- Practice address
- 570 Kirts Blvd Ste 231
Troy, MI 48084-4156 - Phone
- (248) 269-1309
- NPI assigned
- May 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802076082 | MI | Primary |
Addresses
Primary practice location
570 Kirts Blvd Ste 231
Troy, MI 48084-4156
Mailing address
825 Park Ave
Royal Oak, MI 48067-2227
Phone (248) 320-9177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6802076082 | Other | MI | BACHELOR'S SOCIAL WORKER LICENSE |
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 |
|---|---|---|---|
| 6802076082 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1740771872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 PARK AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672227",
"telephone_number": "248-320-9177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 KIRTS BLVD STE 231",
"city": "TROY",
"state": "MI",
"postal_code": "480844156",
"telephone_number": "248-269-1309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDREN",
"first_name": "DEBRA",
"middle_name": "GAYLE",
"name_prefix": "Ms.",
"credential": "LICENSED BACHELOR'S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-24",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802076082",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACHELOR'S SOCIAL WORKER LICENSE",
"identifier": "6802076082",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
- Anthony James Hencsie, MD
- James G Henderson, MD
- Makyah Henderson
- Samantha Grace Henderson, PA-C
- Brenna Nicole Hendler
- Henry Ford Behavioral Health- Troy Medical Center (Henry Ford Health System)
- Henry Ford Behaviorl Health- Troy Medical Center
- Henry Ford Health System (Henry Ford Medical Center Pharmacy)
- Henry Ford Health System (Greenfield Health Systems)
- Henry Ford Health System (Henry Ford - CSI Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.