Individual provider Active NPI

Trudy Harbaum, LMSW

  • Clinical Social Worker
  • Boyne City, MI
National Provider Identifier
1023590924
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801103248 Issued in MI
Practice address
5 W Main St Unit 3
Boyne City, MI 49712-3700
Phone
(231) 881-5001
Fax
(231) 344-6100
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 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 6801103248 MI Primary

Addresses

Primary practice location

5 W Main St Unit 3
Boyne City, MI 49712-3700

Mailing address

5 W Main St Unit 3
Boyne City, MI 49712-3700
Phone (231) 459-8886

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@pyramidofhope.com Direct

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
I20231228000412 MI Practitioner - Clinical Social Worker 4688024086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pyramid of Hope CounselingGroup PAC ID 1456721943, 3 clinicians

Practice addresses (Care Compare)

5 W Main St
Unit 3
Boyne City, MI 49712-3700
Phone (231) 881-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801103248MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pyramid of Hope Counseling Clinical CurrentSince Dec 1, 2023 Accepting new patients

Locations

5 W Main St
Unit 3
Boyne City, MI 49712
Phone (231) 881-5001

Organizations & group practices 1

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1023590924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W MAIN ST UNIT 3",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497123700",
            "telephone_number": "231-459-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W MAIN ST UNIT 3",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497123700",
            "telephone_number": "231-881-5001",
            "fax_number": "231-344-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBAUM",
        "first_name": "TRUDY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pyramidofhope.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Requests for Services",
            "address_1": "5 W Main St Unit 3",
            "city": "Boyne City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497123700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boyne City, MI

Sources for this page

Verify at the official NPI Registry.