Active NPI
Deanna Phon Nobouphasavanh
- Social Worker
- Troy, MI
National Provider Identifier
1861101552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1225 E Big Beaver Rd
Troy, MI 48083-1905 - Phone
- (248) 524-8801
- NPI assigned
- Nov 21, 2022
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1225 E Big Beaver Rd
Troy, MI 48083-1905
Mailing address
1225 E Big Beaver Rd
Troy, MI 48083-1905
Phone (248) 524-8801
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1861101552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 E BIG BEAVER RD",
"city": "TROY",
"state": "MI",
"postal_code": "480831905",
"telephone_number": "248-524-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 E BIG BEAVER RD",
"city": "TROY",
"state": "MI",
"postal_code": "480831905",
"telephone_number": "248-524-8801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOBOUPHASAVANH",
"first_name": "DEANNA",
"middle_name": "PHON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-21",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.