Individual provider Active NPI

Joseph Petricca, MSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1750756763
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091898 Issued in MI
Practice address
2010 Hogback Rd Ste 6G
Ann Arbor, MI 48105-8800
Phone
(734) 386-0041
NPI assigned
Dec 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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 6801091898 MI Primary

Addresses

Primary practice location

2010 Hogback Rd Ste 6G
Ann Arbor, MI 48105-8800

Mailing address

2010 Hogback Rd Ste 6G
Ann Arbor, MI 48105-8800
Phone (734) 386-0041

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801091898MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1750756763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 HOGBACK RD STE 6G",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481058800",
            "telephone_number": "734-386-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 HOGBACK RD STE 6G",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481058800",
            "telephone_number": "734-386-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICCA",
        "first_name": "JOSEPH",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-02",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.