Active NPI
Tiara Nicole Crutchfield
- Social Worker
- Southfield, MI
National Provider Identifier
1760151765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 17320 W 12 Mile Rd
Southfield, MI 48076-2100 - Phone
- (248) 727-3456
- NPI assigned
- Sep 13, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
17320 W 12 Mile Rd
Southfield, MI 48076-2100
Mailing address
29780 Wildbrook Dr
Southfield, MI 48034-7615
Phone (248) 974-3618
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcerecords.essmichigan@direct.mihin.net | Easterseals MORC Health Care, Inc. |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients | |
| Southfield Mental Health Associates PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Southfield, MI
- NPI 1619015872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1760151765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29780 WILDBROOK DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480347615",
"telephone_number": "248-974-3618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17320 W 12 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762100",
"telephone_number": "248-727-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUTCHFIELD",
"first_name": "TIARA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-13",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pcerecords.essmichigan@direct.mihin.net",
"affiliation": "Y",
"affiliationName": "Easterseals MORC Health Care, Inc.",
"address_1": "2399 E Walton Blvd",
"city": "Auburn Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483261955",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.