Individual provider Active NPI

Robert Marshall II, LMSW

  • Clinical Social Worker
  • Port Huron, MI
National Provider Identifier
1013498625
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801120646 Issued in MI
Practice address
3111 Electric Ave
Port Huron, MI 48060-8127
Phone
(810) 985-8900
NPI assigned
Aug 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 6801120646 MI Primary

Addresses

Primary practice location

3111 Electric Ave
Port Huron, MI 48060-8127

Mailing address

3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900

Other practice location 1

32100 Telegraph Rd Ste 205
Bingham Farms, MI 48025-2454
Phone (248) 712-4266

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
I20250826004563 MI Practitioner - Clinical Social Worker 7517467137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clair County Community Mental Health AuthorityGroup PAC ID 7416861984, 54 clinicians

Practice addresses (Care Compare)

3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801120646MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair County Community Mental Health Authority CurrentSince Aug 14, 2025 Accepting new patients
St Clair County Community Mental Health Authority CurrentSince Aug 14, 2025 Accepting new patients

Locations

3111 Electric Ave
Port Huron, MI 48060
Phone (810) 985-4747

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1013498625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608127",
            "telephone_number": "810-985-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608127",
            "telephone_number": "810-985-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32100 Telegraph Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Bingham Farms",
            "state": "MI",
            "postal_code": "480252454",
            "country_code": "US",
            "telephone_number": "248-712-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-22",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801120646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.