JENNIFER NIDETZ (NPI# 1255722088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255722088 |
| Entity Type | Individual |
| Full Name | JENNIFER NIDETZ |
| Credential | LMSW |
| Practice Address |
23015 Cheyenne Dr South Lyon MI 48178 |
| Practice Telephone | 7348468297 |
| Mailing Telephone | 7348468297 |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-02-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149015759 | IL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801097243 | MI | Behavioral Health & Social Service Providers |
| Street Address |
23015 CHEYENNE DR |
| City | SOUTH LYON |
| State | MI |
| Zip Code | 48178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231815 | Bhoomi Shah | Pharmacist | 22318 Pontiac Trail, South Lyon, MI 48178 | 2020-06-27 |
| 1649811845 | Center for Emdr and Trauma Therapy | Counselor | 28900 Pontiac Trail, South Lyon, MI 48178 | 2019-09-30 |
| 1295223386 | Cathrine Michelle Arneson | Massage Therapist | 321 Pettibone St. #101a, South Lyon, MI 48178 | 2018-04-25 |
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1003299777 | James Sullivan | Physical Therapy Assistant | 10821 Bouldercrest Drive, South Lyon, MI 48178 | 2015-06-30 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1043633191 | Kwonsoo Kenneth Kim | Anesthesiology | 8854 Stoney Creek Dr., South Lyon, MI 48178 | 2014-01-27 |
| 1285071860 | Ajanthan Sivagurunathan | Student in an Organized Health Care Education/Training Program | 210 North Lafayette, Providence Medical Center - South Lyon, South Lyon, MI 48178 | 2013-05-23 |
| 1184890055 | Yvonne Marie Snyder | Dentist | 100 E Lake St, South Lyon, MI 48178 | 2008-05-01 |
| 1770757700 | Paul L Simon | Dentist | 21800 Pontiac Trail Ste 100, South Lyon, MI 48178 | 2008-04-22 |
| Find all providers in zip 48178 | ||||
| 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 |
|---|---|---|---|---|
| 1568909182 | The Center for Intentional Living, LLC | Social Worker | 12700 Bowers Ln, South Lyon, MI 48178-9133 | 2017-01-20 |
| 1093265134 | Rhonda Beckermeyer | Social Worker | 11798 Willoway Ct, South Lyon, MI 48178-6652 | 2016-10-13 |
| 1992141048 | Monica Juliet Laming | Social Worker | 13149 10 Mile Rd, South Lyon, MI 48178-9114 | 2013-05-16 |
| 1124398557 | Bernadette Di Carlo Pllc | Social Worker | 417 S Lafayette St, Suite112, South Lyon, MI 48178-1458 | 2012-01-02 |
| 1619288636 | Katrina Marie Lorenz | Social Worker | 104 E Lake St Ste C, South Lyon, MI 48178-1409 | 2010-06-24 |
| 1669792958 | Alishia Ebel | Social Worker | 10876 Ridgestone Dr., South Lyon, MI 48178-3276 | 2010-06-09 |
| 1336479005 | Joanne Terry | Social Worker | 22220 Quail Run Cir Unit 1, South Lyon, MI 48178-2608 | 2010-01-01 |
| 1730332834 | Melissa Purdy | Social Worker | 12392 Sunview Ct, South Lyon, MI 48178-8165 | 2008-11-03 |
| 1649441247 | Michelle Hope-ratzlaff | Social Worker | 208 E Mchattie St, Ste 106, South Lyon, MI 48178-1424 | 2008-03-22 |
| 1790836757 | Paul E. Corte | Social Worker | 10603 Gamewood, South Lyon, MI 48178-9354 | 2007-01-16 |
| Find all providers in SOUTH LYON | ||||
| City | SOUTH LYON |
| Zip Code | 48178 |
Please comment or provide details below to improve the information on JENNIFER NIDETZ.
| 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.