Individual provider Active NPI

Lisa Inoue, MSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1003922501
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081902 Issued in MI
Practice address
5340 Plymouth Rd Ste 210
Ann Arbor, MI 48105-9559
Phone
(734) 707-1013
Fax
(734) 345-1012
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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 6801081902 MI Primary

Addresses

Primary practice location

5340 Plymouth Rd Ste 210
Ann Arbor, MI 48105-9559

Mailing address

5331 Plymouth Rd
Ann Arbor, MI 48105-9520
Phone (734) 996-9111

Other identifiers 1

IdentifierTypeStateIssuer
0963791OtherMIBCBS PIN

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
I20061025000495 MI Practitioner - Clinical Social Worker 3779580253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5340 Plymouth Rd
Suite 210
Ann Arbor, MI 48105-9559
Phone (734) 707-1013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801081902MIMDClinical Social Worker
055538NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Inoue LMSW PLLC Clinical CurrentSince May 11, 2016 Accepting new patients
The Mental Health Association of Westchester County, Inc. Clinical PastSince Apr 21, 2008 Accepting new patients
The Mental Health Association of Westchester County - Social Care Network Past Accepting new patients

Locations

5340 Plymouth Rd
Ste 210
Ann Arbor, MI 48105
Phone (734) 335-4747

Organizations & group practices 3

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1003922501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059520",
            "telephone_number": "734-996-9111",
            "fax_number": "734-996-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH RD STE 210",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059559",
            "telephone_number": "734-707-1013",
            "fax_number": "734-345-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INOUE",
        "first_name": "LISA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0963791",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.