Individual provider Active NPI

Avi Yehuda Kohn

  • Clinical Social Worker
  • West Bloomfield, MI
National Provider Identifier
1962149294
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851114086 Issued in MI
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

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826003491 MI Practitioner - Clinical Social Worker 6305385097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851114086MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service Clinical CurrentSince Jul 10, 2024 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

Verify at the official NPI Registry.