Individual provider Active NPI

Nicole Marie Trombley, LMSW

  • Clinical Social Worker
  • Shelby TWP, MI
National Provider Identifier
1750931473
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110719 Issued in MI
Practice address
8072 21 Mile Rd
Shelby TWP, MI 48317-4310
Phone
(586) 932-2700
NPI assigned
Sep 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801096749 MI
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801110719 MI Primary

Addresses

Primary practice location

8072 21 Mile Rd
Shelby TWP, MI 48317-4310

Mailing address

8072 21 Mile Rd
Shelby TWP, MI 48317-4310
Phone (586) 932-2700

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
I20210826002075 MI Practitioner - Clinical Social Worker 5193120301 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801096749MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Professional Counseling, P.C. Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Macomb Family Services, Inc. Clinical CurrentSince Nov 10, 2021 Accepting new patients
Macomb Family Services, Inc Clinical Past Accepting new patients

Locations

124 W Gates St
Ste 103
Bruce Twp, MI 48065
Phone (586) 752-9696

36975 Utica Rd
Ste 103
Clinton Twp, MI 48036
Phone (586) 226-3440

36975 Utica Rd
Ste 104
Clinton Twp, MI 48036
Phone (586) 226-3440

8072 21 Mile Rd
Shelby Township, MI 48317
Phone (586) 491-6909

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/macombfamily/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1750931473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8072 21 MILE RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483174310",
            "telephone_number": "586-932-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8072 21 MILE RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483174310",
            "telephone_number": "586-932-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLEY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-14",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096749",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

Verify at the official NPI Registry.