Individual provider Active NPI

Tina Gutman, LMSW

  • Clinical Social Worker
  • Huntington Woods, MI
National Provider Identifier
1972076503
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097752 Issued in MI
Practice address
13322 Borgman Ave
Huntington Woods, MI 48070-1006
Phone
(248) 416-4644
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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 6801097752 MI Primary

Addresses

Primary practice location

13322 Borgman Ave
Huntington Woods, MI 48070-1006

Mailing address

13322 Borgman Ave
Huntington Woods, MI 48070-1006

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
I20190214001576 MI Practitioner - Clinical Social Worker 6305184441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Happy Mama Counseling PLLCGroup PAC ID 3375968399, 2 clinicians

Practice addresses (Care Compare)

17251 W 12 Mile Rd
Suite 200
Southfield, MI 48076-2140
Phone (248) 416-4644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1972076503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13322 BORGMAN AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13322 BORGMAN AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701006",
            "telephone_number": "248-416-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "TINA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Woods, MI

Sources for this page

Verify at the official NPI Registry.