Individual provider Active NPI

Majida V Kinnard, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1962790139
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2200 Hunt St Ste 545
Detroit, MI 48207-5605
Phone
(248) 469-8479
NPI assigned
Jul 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2200 Hunt St Ste 545
Detroit, MI 48207-5605

Mailing address

361 Keelson Dr
Detroit, MI 48215-3075
Phone (248) 469-8479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • 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
I20120329000428 MI Practitioner - Clinical Social Worker 0941460869 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Alternatives LLC Single Specialty CurrentSince Mar 1, 2025 Accepting new patients
Lotus Holistic Mental Health Services, PLLC Clinical CurrentSince Jun 2, 2024 Accepting new patients

Locations

3281 Coolidge Hwy
Berkley, MI 48072
Phone (313) 915-9138

2200 Hunt St
Ste 545
Detroit, MI 48207
Phone (248) 469-8479

Organizations & group practices 2

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1962790139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 KEELSON DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482153075",
            "telephone_number": "248-469-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HUNT ST STE 545",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482075605",
            "telephone_number": "248-469-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNARD",
        "first_name": "MAJIDA",
        "middle_name": "V",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.