Active NPI
Kyona Tate, LLMSW
- Clinical Social Worker
- Detroit, MI
National Provider Identifier
1770030991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801100178
- Practice address
- 10 Peterboro St
Detroit, MI 48201-2722 - Phone
- (313) 831-3160
- Fax
- (313) 831-2604
- NPI assigned
- Sep 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801100178 | MI | Primary |
Addresses
Primary practice location
10 Peterboro St
Detroit, MI 48201-2722
Mailing address
10 Peterboro St
Detroit, MI 48201
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801100178 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500508800000",
"number": "1770030991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PETERBORO ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PETERBORO ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012722",
"telephone_number": "313-831-3160",
"fax_number": "313-831-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATE",
"first_name": "KYONA",
"credential": "LLMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-06",
"last_updated": "2017-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801100178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.