Doug Derdowski, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801085558 Issued in MI

Practice address

4123 Okemos Road
Eastbrook Plaza
Okemos, MI 48864

Phone

(517) 525-3405

NPI assigned

May 18, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Doug Derdowski, LMSW LLC

  • Clinical Social Worker
  • Okemos, MI
  • NPI 1962121913
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1851748966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E NEWMAN RD",
            "city": "WILLIAMSTON",
            "state": "MI",
            "postal_code": "488959329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 OKEMOS ROAD",
            "address_2": "EASTBROOK PLAZA",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "48864",
            "telephone_number": "517-525-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERDOWSKI",
        "first_name": "DOUG",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085558",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "6801085558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Dennis
• Ella Danielle Denslow
• Kylie Densmore, M.ED, BCBA
• Adriana Dent
• Megan Deraedt, LMSW
• Faith Derouchie
• Will Deruyter
• Chetna Vipul Desai, PT
• Marisa Denise Devries, MD
• Nicole Marie Dewall

• Clinical Social Worker in Okemos, MI
• Providers in Okemos, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.