Active NPI
Mary E. Rodgers, LMSW
- Clinical Social Worker
- Pontiac, MI
National Provider Identifier
1831519008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801084005
- Practice address
- 58 Newberry St
Pontiac, MI 48341-1136 - Phone
- (248) 636-8365
- NPI assigned
- Apr 25, 2014
- 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 | 6801084005 | MI | Primary |
Addresses
Primary practice location
58 Newberry St
Pontiac, MI 48341-1136
Mailing address
58 Newberry St
Pontiac, MI 48341-1136
Phone (248) 636-8365
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801084005 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398384000000",
"number": "1831519008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 NEWBERRY ST",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411136",
"telephone_number": "248-636-8365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 NEWBERRY ST",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411136",
"telephone_number": "248-636-8365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "MARY",
"middle_name": "E.",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-25",
"last_updated": "2014-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801084005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.