Dorothy Eileen Tetreault, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801081579 Issued in MI

Practice address

569 Wildwood Ave
Unit 4
Jackson, MI 49201-1048

Phone

(517) 788-6404

Fax

(517) 787-8170

NPI assigned

Feb 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1912041344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E MICHIGAN AVE",
            "address_2": "SUITE 209",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023700",
            "telephone_number": "571-787-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 WILDWOOD AVE",
            "address_2": "UNIT 4",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011048",
            "telephone_number": "517-788-6404",
            "fax_number": "517-787-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETREAULT",
        "first_name": "DOROTHY",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.