NPIMap

Organization Active NPI

Apex Behavioral Health Western Wayne

  • Clinical Social Worker
  • Westland, MI
National Provider Identifier
1962779710
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
APEX BEHAVIORAL HEALTH WESTERN WAYNE
Practice address
1547 S Wayne Rd
Westland, MI 48186-5436
Phone
(734) 729-3133
NPI assigned
Nov 22, 2011
Last updated
Nov 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Authorized official

Name
Jill Blackson, LMSQNPI 1306008958
Title
Coordinator
Phone
(734) 405-0175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1547 S Wayne Rd
Westland, MI 48186-5436

Mailing address

1547 S Wayne Rd
Westland, MI 48186-5436
Phone (734) 729-3133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120411000775 MI Part B Supplier - Clinic/Group Practice 4183885593 Receives reassigned benefits from 10 practitioners
Practice locations: Westland, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1962779710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 S WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481865436",
            "telephone_number": "734-729-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 S WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481865436",
            "telephone_number": "734-729-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APEX BEHAVIORAL HEALTH WESTERN WAYNE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "BLACKSON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "734-405-0175",
        "authorized_official_credential": "LMSQ"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.