Individual provider Active NPI

Laurin Becca Jozlin, LMSW

  • Clinical Social Worker
  • Berkley, MI
National Provider Identifier
1972881456
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093071 Issued in MI
Practice address
2615 W 12 Mile Rd
Berkley, MI 48072-1627
Phone
(248) 858-7766
Fax
(248) 858-8227
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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 6801093071 MI Primary

Addresses

Primary practice location

2615 W 12 Mile Rd
Berkley, MI 48072-1627

Mailing address

2615 W 12 Mile Rd Ste 119
Berkley, MI 48072-1627
Phone (248) 987-8509

Other identifiers 1

IdentifierTypeStateIssuer
1883825MedicaidMI

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

LicenseStateTypeSpecialty
6801093071MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1972881456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 W 12 MILE RD STE 119",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721627",
            "telephone_number": "248-987-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 W 12 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721627",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOZLIN",
        "first_name": "LAURIN",
        "middle_name": "BECCA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.