Individual provider Active NPI

Denisha Beasley

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1891556130
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801115882 Issued in MI
Practice address
28248 Franklin Rd
Southfield, MI 48034-1659
Phone
(313) 384-0058
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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 6801115882 MI Primary

Addresses

Primary practice location

28248 Franklin Rd
Southfield, MI 48034-1659

Mailing address

2779 Wisconsin Rd
Troy, MI 48083-6127
Phone (313) 384-0058

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

State licenses

LicenseStateTypeSpecialty
6801115882MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Restorative Services and Solutions Clinical Current Accepting new patients
Revived Mind Counseling Services Social Worker PastSince Sep 13, 2022 Accepting new patients

Locations

28248 Franklin Rd
Southfield, MI 48034
Phone (248) 598-4969

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1891556130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 WISCONSIN RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836127",
            "telephone_number": "313-384-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28248 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341659",
            "telephone_number": "313-384-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "DENISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.