Individual provider Active NPI

Matthew David Rosenberg, LMSW

  • Clinical Social Worker
  • Warren, MI
National Provider Identifier
1902989494
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801069266 Issued in MI
Practice address
31201 Chicago Rd S
Suite A102
Warren, MI 48093-5527
Phone
(586) 275-0657
Fax
(586) 275-0723
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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 6801069266 MI Primary

Addresses

Primary practice location

31201 Chicago Rd S
Suite A102
Warren, MI 48093-5527

Mailing address

31201 Chicago Rd S
Suite A102
Warren, MI 48093-5527
Phone (586) 275-0657

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1902989494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S",
            "address_2": "SUITE A102",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935527",
            "telephone_number": "586-275-0657",
            "fax_number": "586-275-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S",
            "address_2": "SUITE A102",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935527",
            "telephone_number": "586-275-0657",
            "fax_number": "586-275-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801069266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.