Active NPI
Wanda Olugbala, LMSW
- Social Worker
- Detroit, MI
National Provider Identifier
1972740470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801072064
- Practice address
- 4700 Tireman St
Detroit, MI 48204-4243 - Phone
- (313) 897-5961
- NPI assigned
- Jan 21, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801072064 | MI | Primary |
Addresses
Primary practice location
4700 Tireman St
Detroit, MI 48204-4243
Mailing address
17421 Telegraph Rd
Detroit, MI 48219-3165
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801072064 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1972740470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17421 TELEGRAPH RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482193165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 TIREMAN ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482044243",
"telephone_number": "313-897-5961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUGBALA",
"first_name": "WANDA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-21",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801072064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.