Active NPI
Tacara Lakaisha Woods, LMSW, CTP-C
- Clinical Social Worker
- Warren, MI
National Provider Identifier
1770071201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801097458
- Practice address
- 23543 Bolam Ave
Warren, MI 48089-2232 - Phone
- (313) 308-5510
- Fax
- (313) 429-7649
- NPI assigned
- Apr 30, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801097458 | MI | Primary |
Addresses
Primary practice location
23543 Bolam Ave
Warren, MI 48089-2232
Mailing address
PO Box 753
Eastpointe, MI 48021-0753
Phone (313) 308-5510
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1770071201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 753",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480210753",
"telephone_number": "313-308-5510",
"fax_number": "313-429-7649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23543 BOLAM AVE",
"city": "WARREN",
"state": "MI",
"postal_code": "480892232",
"telephone_number": "313-308-5510",
"fax_number": "313-429-7649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "TACARA",
"middle_name": "LAKAISHA",
"credential": "LMSW, CTP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-30",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801097458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
- Jennifer Ann Wong, OD
- Todd Robert Wood, DDS
- Patrick John Woodman, D.O.
- Woods Cardiovascular Interna Medicine Associastes, P.C.
- Woods Cardiovascular Internal Medicine Associates, P.C.
- Woodward Detroit CVS LLC
- Woodward Detroit CVS, L.L.C.
- Woodward Detroit CVS, L.L.C.
- Woodward Detroit CVS, L.L.C.
- Woodward Detroit CVS, L.L.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.