Active NPI
Avi Yehuda Kohn
- Clinical Social Worker
- West Bloomfield, MI
National Provider Identifier
1962149294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851114086
- Practice address
- 6555 W Maple Rd
West Bloomfield, MI 48322-4926 - Phone
- (248) 592-2313
- NPI assigned
- May 18, 2022
- Sex
- Male
- 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 | 6851114086 | MI | Primary |
Addresses
Primary practice location
6555 W Maple Rd
West Bloomfield, MI 48322-4926
Mailing address
15677 Jeanette St
Southfield, MI 48075-6002
Phone (248) 763-1051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851114086 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jewish Family Service | Clinical | Current | Accepting new patients |
Locations
6555 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 592-2300
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1962149294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15677 JEANETTE ST",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480756002",
"telephone_number": "248-763-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6555 W MAPLE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483224926",
"telephone_number": "248-592-2313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHN",
"first_name": "AVI",
"middle_name": "YEHUDA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-18",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6851114086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.