Individual provider Active NPI

Borhan I Rais, LMSW

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1891748455
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801017757 Issued in MI
Practice address
1225 E Big Beaver Rd
Troy, MI 48083-1905
Phone
(248) 524-8801
Fax
(248) 524-8850
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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 6801017757 MI Primary

Addresses

Primary practice location

1225 E Big Beaver Rd
Troy, MI 48083-1905

Mailing address

932 Canterbury Dr
Madison HTS, MI 48071-2278
Phone (248) 585-8593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060731000451 MI Practitioner - Clinical Social Worker 5799798104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

24715 Little Mack Ave
Suite 200
Saint Clair Shores, MI 48080-3207
Phone (586) 777-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801017757MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Sep 21, 2019 Accepting new patients
Training and Treatment Innovations Inc CurrentSince Apr 25, 2018 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Sep 21, 2019 Accepting new patients
Training & Treatment Innovations Inc CurrentSince Apr 25, 2018 Accepting new patients

Locations

1450 S Lapeer Rd
Oxford, MI 48371
Phone (248) 969-9932

19501 E 8 Mile Rd
St Clr Shores, MI 48080
Phone (810) 777-9000

24715 Little Mack Ave
Ste 200
St Clr Shores, MI 48080
Phone (586) 777-9000

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

1225 E Big Beaver Rd
Troy, MI 48083
Phone (248) 524-8801

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.borhanrais@150339.advancedmd-direct.com

Organizations & group practices 4

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1891748455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 CANTERBURY DR",
            "city": "MADISON HTS",
            "state": "MI",
            "postal_code": "480712278",
            "telephone_number": "248-585-8593"
        },
        {
            "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",
            "fax_number": "248-524-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIS",
        "first_name": "BORHAN",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801017757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.