Integrated Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801092051 Issued in MI

Legal business name

INTEGRATED WELLNESS

Practice address

220 Bagley St
Suite 1015
Detroit, MI 48226-1400

Phone

(313) 689-3076

NPI assigned

Nov 15, 2016

Last updated

Nov 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Natasha Wilson, LMSWNPI 1285940932

Title

Owner

Phone

(313) 689-3076

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Natasha Wilson, LMSW

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1285940932
  NPD (past) Authorized official

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1871035345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 442589",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482442589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BAGLEY ST",
            "address_2": "SUITE 1015",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482261400",
            "telephone_number": "313-689-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-689-3076",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Detroit, MI
• Providers in Detroit, 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 Nov 15, 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.