Individual provider Active NPI

Stephani McIsaac, LMSW

  • Clinical Social Worker
  • Grosse Pointe Woods, MI
National Provider Identifier
1003213356
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094601 Issued in MI
Practice address
20956 Mack Ave
Grosse Pointe Woods, MI 48236-1355
Phone
(248) 660-0753
NPI assigned
Dec 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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 6801094601 MI Primary

Addresses

Primary practice location

20956 Mack Ave
Grosse Pointe Woods, MI 48236-1355

Mailing address

1608 Hampton Rd
Grosse Pointe Woods, MI 48236-1304
Phone (248) 739-6249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210402000384 MI Practitioner - Clinical Social Worker 6608283965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health Eastwood Behavioral HealthGroup PAC ID 2163324492, 51 clinicians

Practice addresses (Care Compare)

17250 Farmington Rd
Livonia, MI 48152-3151
Phone (734) 425-4070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094601MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Eastwood Behavioral Health Social Worker CurrentSince Apr 1, 2021 Accepting new patients
Henry Ford Health Eastwood Behavioral Health Social Worker PastSince Feb 19, 2023 Accepting new patients

Locations

17250 Farmington Rd
Livonia, MI 48152
Phone (734) 425-4070

24055 Jefferson Ave
Ste 103
Saint Clair Shores, MI 48080
Phone (586) 445-2210

2800 Livernois Rd
Ste 500
Troy, MI 48083
Phone (586) 753-0400

Interoperability endpoints

  • Direct secure messaging: smcisaac1140995@direct.hfhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1003213356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 HAMPTON RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361304",
            "telephone_number": "248-739-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20956 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361355",
            "telephone_number": "248-660-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCISAAC",
        "first_name": "STEPHANI",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.