Active NPI
Irene Lane
- Clinical Social Worker
- Southfield, MI
National Provider Identifier
1942834809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6802085447
- Practice address
- 24600 Northwestern Hwy
Southfield, MI 48075-2471 - Phone
- (248) 871-1474
- Fax
- (248) 994-2639
- NPI assigned
- Feb 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802085447 | MI | |
| Clinical Social Worker | 1041C0700X | 6802085447 | MI | Primary |
Addresses
Primary practice location
24600 Northwestern Hwy
Southfield, MI 48075-2471
Mailing address
24600 Northwestern Hwy
Southfield, MI 48075-2471
Phone (248) 871-1474
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 |
|---|---|---|---|
| 6802085447 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582848000000",
"number": "1942834809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24600 NORTHWESTERN HWY",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752471",
"telephone_number": "248-871-1474",
"fax_number": "248-994-2639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24600 NORTHWESTERN HWY",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752471",
"telephone_number": "248-871-1474",
"fax_number": "248-994-2639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "IRENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-28",
"last_updated": "2020-02-28",
"certification_date": "2020-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "MI",
"license": "6802085447",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6802085447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.