AUTUMN NICOLE WHITESIDE LLMSW
NPI 1265105878
Social Worker in Detroit, MI

Q: What is Autumn Whiteside's NPI number?

The NPI number for Autumn Whiteside is 1265105878. It was assigned to this individual provider in the NPPES registry on July 29, 2021.

Q: What is Autumn Whiteside's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Autumn Whiteside was last updated on July 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 29, 2021PECOS Enrolled

882 OAKMAN BLVD STE D, DETROIT, MI 48238(313) 961-7990(313) 883-6261 Get Directions Write a Review

NPPES record last updated: July 29, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Autumn Nicole Whiteside Llmsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUTUMN NICOLE WHITESIDE LLMSW (NPI 1265105878) is an individual social worker in Detroit, Michigan, licensed in Michigan (6851107419) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1265105878

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameAUTUMN NICOLE WHITESIDECredential: LLMSW

Location Address882 OAKMAN BLVD STE DDetroit, MI 48238-4019

Mailing Address27225 Devonshire StSouthfield, MI 48076-5639 · (248) 390-0956

Phone(313) 961-7990

Fax(313) 883-6261

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateJuly 29, 2021

NPPES CertifiedJuly 29, 2021

✔ NPI 1265105878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in MI · 6851107419

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

882 OAKMAN BLVD STE D, Detroit, MI 48238

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn Nicole Whiteside Llmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5193293264

PECOS Enrollment IDI20260506003585

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. PATRINIA GRAYSON

Social Worker