John Kettley, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801010281 Issued in MI

Practice address

1221 W North Territorial Rd
Ann Arbor, MI 48105-9222

Phone

(734) 358-7116

NPI assigned

Mar 17, 2017

Last updated

Mar 17, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1942741301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W NORTH TERRITORIAL RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059222",
            "telephone_number": "734-358-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W NORTH TERRITORIAL RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059222",
            "telephone_number": "734-358-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTLEY",
        "first_name": "JOHN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "6801010281",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801010281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott William Ketcham, MD
• Cynthia Leigh Ketcherside, MA, LPC, NCC, ACS
• Sarah Ann Ketelhut, PA
• Surekha Ketha, M.D.
• Laura Sue Kett, OTR
• Tosh Ketz
• Tiffie Manyee Keung, MD
• Kevin T Cook DDS PLLC
• Kevin Wieczerza, DDS, PLLC (Wolverine Family Dentistry)
• Rachel Elizabeth Key, PA-C

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, 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 Mar 17, 2017; 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.