Individual provider Active NPI

Jennifer Lindsey Doktorcik, MSW

  • Clinical Social Worker
  • Ferndale, MI
National Provider Identifier
1942434766
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
680108867 Issued in MI
Practice address
825 Leroy St
Ferndale, MI 48220-1601
Phone
(949) 468-7086
NPI assigned
May 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 680108867 MI Primary
Clinical Social Worker 1041C0700X ASW 20719 CA

Addresses

Primary practice location

825 Leroy St
Ferndale, MI 48220-1601

Mailing address

825 Leroy St
Ferndale, MI 48220-1601
Phone (949) 468-7086

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
ASW 20719CAMDClinical Social Worker
680108867MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1942434766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 LEROY ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201601",
            "telephone_number": "949-468-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 LEROY ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201601",
            "telephone_number": "949-468-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOKTORCIK",
        "first_name": "JENNIFER",
        "middle_name": "LINDSEY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "680108867",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 20719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.