Individual provider Active NPI

Mary Jo Robbins, LMSW ACSW LMFT

  • Clinical Social Worker
  • Norton Shores, MI
National Provider Identifier
1003857426
Registry record updated Oct 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801033857 Issued in MI
Practice address
800 E Ellis Rd
Suite 221
Norton Shores, MI 49441-5622
Phone
(231) 722-8500
Fax
(517) 579-0272
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801033857 MI Primary
Marriage & Family Therapist 106H00000X 4101005756 MI

Addresses

Primary practice location

800 E Ellis Rd
Suite 221
Norton Shores, MI 49441-5622

Mailing address

5124 Brookwood Cir
Montague, MI 49437-1001
Phone (231) 894-5011

Other identifiers 2

IdentifierTypeStateIssuer
8008901560OtherMIBLUE CROSS BLUE SHIELD
263864000OtherMAGELLAN

Other names 1

  • Ms. Mary Jo Dempsey Professional name

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
I20070103000010 MI Practitioner - Clinical Social Worker 3476553157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

800 E Ellis
Suite 211
Norton Shores, MI 49441-5646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801033857MIMDClinical Social Worker
4101005756MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Jo Dempsey PC Clinical CurrentSince Oct 17, 2006 Accepting new patients
Harbor Psychological Associates PC PastSince Oct 8, 1997 Accepting new patients

Locations

800 E Ellis Rd
Ste 221
Norton Shores, MI 49441
Phone (231) 722-8500

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351382400000",
    "number": "1003857426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 BROOKWOOD CIR",
            "city": "MONTAGUE",
            "state": "MI",
            "postal_code": "494371001",
            "telephone_number": "231-894-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E ELLIS RD",
            "address_2": "SUITE 221",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494415622",
            "telephone_number": "231-722-8500",
            "fax_number": "517-579-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBBINS",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LMSW ACSW LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801033857",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005756",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8008901560",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "263864000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DEMPSEY",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "LMSW ACSW LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.