Individual provider Active NPI

Tanisha A Moir, LMSW CAADC

  • Social Worker
  • Southfield, MI
National Provider Identifier
1760528749
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801090844 Issued in MI
Practice address
26677 W 12 Mile Rd
Southfield, MI 48034-1514
Phone
(313) 930-0757
NPI assigned
Jan 29, 2007
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1-04424 MI
Social Worker 104100000X 6801090844 MI Primary

Addresses

Primary practice location

26677 W 12 Mile Rd
Southfield, MI 48034-1514

Mailing address

26677 W 12 Mile Rd
Southfield, MI 48034-1514
Phone (313) 930-0757

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
I20160818000270 MI Practitioner - Clinical Social Worker 8628363439 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-04424MIMDAddiction (Substance Use Disorder) Counselor
6801090844MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Lainie Epstein PLLC CurrentSince Jan 1, 2020 Accepting new patients
Transforming Recovery Education and Therapy PLLC CurrentSince Mar 19, 2021 Accepting new patients

Locations

20411 W 12 Mile Rd
Ste 101
Southfield, MI 48076
Phone (248) 354-1888

26677 W 12 Mile Rd
Southfield, MI 48034
Phone (248) 234-4816

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, 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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1760528749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "313-930-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "313-930-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOIR",
        "first_name": "TANISHA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LMSW CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "1-04424",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801090844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.