Active NPI
Robert A Kercorian, LMSW
- Clinical Social Worker
- Clinton Township, MI
National Provider Identifier
1841551876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801003021
- Practice address
- 42669 Garfield Rd
Clinton Township, MI 48038-5036 - Phone
- (586) 412-5321
- Fax
- (586) 412-5327
- NPI assigned
- Jun 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801003021 | MI | Primary |
| Marriage & Family Therapist | 106H00000X | 4101000530 | MI |
Addresses
Primary practice location
42669 Garfield Rd
Clinton Township, MI 48038-5036
Mailing address
6549 Town Center Dr
Suite a
Clarkston, MI 48346-4824
Phone (248) 620-6400
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00260F7 | Other | MI | HAP |
| 750910402 | Other | MI | BCBSFED |
| 750910402 | Other | MI | BCTR |
| 750910402 | Other | MI | BC OOS |
| 032919 | Other | MI | MIDWEST HEALTH PLAN |
| 750910402 | Other | MI | BCBS MEDICARE ADVANTAGE |
| 750910402 | Other | MI | BC CHRYSLER |
| XX19153 | Other | MI | HEALTHPLUS |
| 750910402 | Other | MI | BCMI |
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 |
|---|---|---|---|
| 4101000530 | MI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338940800000",
"number": "1841551876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6549 TOWN CENTER DR",
"address_2": "SUITE A",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483464824",
"telephone_number": "248-620-6400",
"fax_number": "248-620-6405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42669 GARFIELD RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480385036",
"telephone_number": "586-412-5321",
"fax_number": "586-412-5327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERCORIAN",
"first_name": "ROBERT",
"middle_name": "A",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-06",
"last_updated": "2012-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801003021",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101000530",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAP",
"identifier": "00260F7",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSFED",
"identifier": "750910402",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCTR",
"identifier": "750910402",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC OOS",
"identifier": "750910402",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWEST HEALTH PLAN",
"identifier": "032919",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MEDICARE ADVANTAGE",
"identifier": "750910402",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC CHRYSLER",
"identifier": "750910402",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPLUS",
"identifier": "XX19153",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCMI",
"identifier": "750910402",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.