Active NPI
Manjula Kaza-Egan
- Social Worker
- Huntington Woods, MI
National Provider Identifier
1831538198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801093902
- Practice address
- 13116 Balfour Ave
Huntington Woods, MI 48070-1701 - Phone
- (248) 200-6061
- NPI assigned
- Jun 20, 2013
- Last updated
- Jun 20, 2013
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801093902 | MI | Primary |
Addresses
Primary practice location
13116 Balfour Ave
Huntington Woods, MI 48070-1701
Mailing address
13116 Balfour Ave
Huntington Woods, MI 48070
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 |
|---|---|---|---|
| 6801093902 | MI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Pearl Wellness, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Manjula Egan, LMSW
- Clinical Social Worker
- Southfield, MI
- NPI 1578117990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1831538198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13116 BALFOUR AVE",
"city": "HUNTINGTON WOODS",
"state": "MI",
"postal_code": "48070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13116 BALFOUR AVE",
"city": "HUNTINGTON WOODS",
"state": "MI",
"postal_code": "480701701",
"telephone_number": "248-200-6061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZA-EGAN",
"first_name": "MANJULA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-20",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801093902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Woods, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.