Individual provider Active NPI

Laurel Jean Rebenstock, LMSW, CAADC

  • Clinical Social Worker
  • West Bloomfield, MI
National Provider Identifier
1033370747
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
680108223 Issued in MI
Practice address
5600 W Maple Rd Ste B212
West Bloomfield, MI 48322-3787
Phone
(248) 605-5049
NPI assigned
Jun 24, 2008
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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 680108223 MI Primary

Addresses

Primary practice location

5600 W Maple Rd Ste B212
West Bloomfield, MI 48322-3787

Mailing address

5600 W Maple Rd Ste B212
West Bloomfield, MI 48322-3787
Phone (248) 605-5049

Other names 1

  • Miss Laurel Jean Rebenstock Former 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
I20080917000532 MI Practitioner - Clinical Social Worker 1456428499 Reassigns benefits to 1 organization
Practice locations: West Bloomfield, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5600 W Maple Rd
Suite B212
West Bloomfield, MI 48322-3787
Phone (248) 605-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
680108223MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Perspectives Time Well Spent Counseling and Resource Cent Clinical CurrentSince Oct 5, 2018 Accepting new patients
Gales Institute on Aging and Family Counseling, LLC Clinical CurrentSince Jan 29, 2024 Accepting new patients
Aspire Therapy Services, PLLC PastSince Jul 9, 2023 Accepting new patients
Carol a. Roekle, M.D., P.C. Past Accepting new patients

Locations

5600 W Maple Rd
Ste B212
West Bloomfield, MI 48322
Phone (248) 425-8981

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1033370747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD STE B212",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223787",
            "telephone_number": "248-605-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD STE B212",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223787",
            "telephone_number": "248-605-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBENSTOCK",
        "first_name": "LAUREL",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "680108223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "REBENSTOCK",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "credential": "LMSW, CAAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.