Mary Diane Junglas, PH.D, LMSW, CAAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801057791 Issued in MI

Practice address

15000 Gratiot Ave
Detroit, MI 48205-1973

Phone

(313) 245-0600

NPI assigned

Sep 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1760799183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51108 SHELBY RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164051",
            "telephone_number": "586-254-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051973",
            "telephone_number": "313-245-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGLAS",
        "first_name": "MARY",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PH.D, LMSW, CAAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-02432",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801057791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gjergj George Juncaj, NP
• Junction Clinic
• Junction Clinic Health Center PLLC
• Aarti Juneja, ANP
• Ganeem Kuar Juneja, M.D.
• Alexis Junior
• Jamie D Junior, CCHW, CPM, SST
• Jupiter Wellness Co LLC
• Robert Andrew Jurado, M.D.
• Kyle Nicolas Jurayj, MD

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.