Active NPI
Marie C Petricca, MSW ACSW CACI LMSW
- Clinical Social Worker
- Dearborn Heights, MI
National Provider Identifier
1922140490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801017915
- Practice address
- 20382 Van Born Road
Catholic Social Services of Wayne County
Dearborn Heights, MI 48125 - Phone
- (313) 792-9286
- Fax
- (313) 792-0444
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801017915 | MI | Primary |
Addresses
Primary practice location
20382 Van Born Road
Catholic Social Services of Wayne County
Dearborn Heights, MI 48125
Mailing address
20382 Van Born Rd
Catholic Social Services of Wayne County
Dearborn Heights, MI 48125
Phone (313) 792-9286
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801017915 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922140490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20382 VAN BORN RD",
"address_2": "CATHOLIC SOCIAL SERVICES OF WAYNE COUNTY",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "48125",
"telephone_number": "313-792-9286",
"fax_number": "313-792-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20382 VAN BORN ROAD",
"address_2": "CATHOLIC SOCIAL SERVICES OF WAYNE COUNTY",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "48125",
"telephone_number": "313-792-9286",
"fax_number": "313-792-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRICCA",
"first_name": "MARIE",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "MSW ACSW CACI LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801017915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.