Individual provider Active NPI

Doreen McComas

  • Social Worker
  • New Haven, MI
National Provider Identifier
1932206398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802061366 Issued in MI
Practice address
58144 Gratiot Avenue
New Haven, MI 48048
Phone
(810) 794-4982
Fax
(810) 794-4407
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802061366 MI Primary

Addresses

Primary practice location

58144 Gratiot Avenue
New Haven, MI 48048

Mailing address

58144 Gratiot Avenue
P.O. Box 480430
New Haven, MI 48048
Phone (810) 794-4982

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

LicenseStateTypeSpecialty
6802061366MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932206398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58144 GRATIOT AVENUE",
            "address_2": "P.O. BOX 480430",
            "city": "NEW HAVEN",
            "state": "MI",
            "postal_code": "48048",
            "telephone_number": "810-794-4982",
            "fax_number": "810-794-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58144 GRATIOT AVENUE",
            "city": "NEW HAVEN",
            "state": "MI",
            "postal_code": "48048",
            "telephone_number": "810-794-4982",
            "fax_number": "810-794-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMAS",
        "first_name": "DOREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802061366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, 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.

Verify at the official NPI Registry.