DONALD RAY CISCO JR. (NPI# 1205456308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205456308 |
| Entity Type | Individual |
| Full Name | DONALD RAY CISCO JR. |
| Credential | B.A. S.S.T. |
| Practice Address |
14799 Dix Toledo Rd Southgate MI 48195-2507 |
| Practice Telephone | 7343248326 |
| Mailing Telephone | 7343248326 |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-04-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 6803087132 | 05 |
| Street Address |
14799 DIX TOLEDO RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326297672 | Michael Paul Lingar | Psychologist | 14799 Dix Toledo Rd, Suite 1100, Southgate, MI 48195-2507 | 2008-09-11 |
| 1457961419 | Amber Iyana Threat | Social Worker | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-08-05 |
| 1336757764 | Caroline Radzwion | Social Worker | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-07-22 |
| 1235747577 | Rachel Gonzalez | Social Worker | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-07-22 |
| 1609494046 | Dequindre Lashay Jernigan | Counselor | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-07-13 |
| 1043837305 | Brian Adam Demoisey | Social Worker | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-07-02 |
| 1215554803 | Sheila Renee Hatton | Nurse Practitioner | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-06-29 |
| 1265053557 | Tamara Reneise Ellis | Social Worker | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-04-28 |
| 1497375596 | Anupamdeep K Sohal | Social Worker | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-04-20 |
| 1720614266 | Carin B Wayne | Registered Nurse | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-03-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
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| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730705245 | Mindful Connections LLC | Social Worker | 13559 Wesley St, Southgate, MI 48195-1716 | 2020-06-20 |
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1063949279 | Paula Marie Hernandez | Social Worker | 19275 Northline Rd Bldg 7, Southgate, MI 48195-2220 | 2017-05-18 |
| 1497290480 | Erica Crlencic | Social Worker | 15905 Waverly St, Southgate, MI 48195-3076 | 2016-12-29 |
| 1043623283 | Lindsey Duda | Social Worker | 13305 Reeck Road, Southgate, MI 48195-3197 | 2014-06-05 |
| 1386953511 | Rashida Folade Mcclure | Social Worker | 13330 Greenview Dr Apt 108, Southgate, MI 48195-3425 | 2010-10-06 |
| 1346556735 | Michelle Margaret Mertic | Social Worker | 13101 Allen Rd Ste 200, Southgate, MI 48195-2216 | 2010-08-24 |
| 1316126824 | Charlotte Beachem | Social Worker | 13305 Reeck Ct, Southgate, MI 48195 | 2007-10-31 |
| 1871719690 | Frank Steve Jacob | Social Worker | 13101 Allen Rd Bldg 4, Southgate, MI 48195-2216 | 2007-04-18 |
| 1225252562 | Elizabeth C. Davis | Social Worker | 19291 Northline Road, Southgate, MI 48195 | 2007-04-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.