Individual provider Active NPI

Diana Pelshaw, MSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1871222760
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092219 Issued in MI
Practice address
882 Oakman Blvd
Detroit, MI 48238-3710
Phone
(313) 883-7246
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801092219 MI Primary

Addresses

Primary practice location

882 Oakman Blvd
Detroit, MI 48238-3710

Mailing address

3919 Aquarina St
Waterford, MI 48329-2115
Phone (248) 719-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092219MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1871222760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 AQUARINA ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483292115",
            "telephone_number": "248-719-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 OAKMAN BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383710",
            "telephone_number": "313-883-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELSHAW",
        "first_name": "DIANA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.