Active NPI
Jacqueline Holt
- Clinical Social Worker
- Southfield, MI
National Provider Identifier
1952825713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 16000 W 9 Mile Rd Ste 607
Southfield, MI 48075-4851 - Phone
- (313) 659-6958
- NPI assigned
- Aug 2, 2017
- 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 | Primary |
Addresses
Primary practice location
16000 W 9 Mile Rd Ste 607
Southfield, MI 48075-4851
Mailing address
19921 Prest St
Detroit, MI 48235-1808
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501632000000",
"number": "1952825713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19921 PREST ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482351808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16000 W 9 MILE RD STE 607",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754851",
"telephone_number": "313-659-6958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-02",
"last_updated": "2017-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"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 Aug 2, 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.