NPIMap

Organization Active NPI

Doluge Behavioral Services PLLC

  • Social Worker
  • Detroit, MI
National Provider Identifier
1902086218
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801019214 Issued in MI
Legal business name
DOLUGE BEHAVIORAL SERVICES PLLC
Practice address
220 W Congress St
2ND Floor
Detroit, MI 48226-3289
Phone
(313) 963-4979
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Gloria Jackson, MSW
Title
MSW
Phone
(313) 963-4979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6801019214 MI Primary

Addresses

Primary practice location

220 W Congress St
2ND Floor
Detroit, MI 48226-3289

Mailing address

220 W Congress St
2ND Floor
Detroit, MI 48226-3289
Phone (313) 963-4979

Other identifiers 1

IdentifierTypeStateIssuer
8008971660OtherMIBLUE CROSS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1902086218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W CONGRESS ST",
            "address_2": "2ND FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482263289",
            "telephone_number": "313-963-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W CONGRESS ST",
            "address_2": "2ND FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482263289",
            "telephone_number": "313-963-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOLUGE BEHAVIORAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "MSW",
        "authorized_official_telephone_number": "313-963-4979",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801019214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8008971660",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.