Individual provider Active NPI

Thomas A Sammon, MSW, LMSW, ACSW

  • Clinical Social Worker
  • Flint, MI
National Provider Identifier
1033860614
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801106518 Issued in MI
Practice address
2222 S Linden Rd Ste J
Flint, MI 48532-5413
Phone
(810) 732-0560
NPI assigned
Jan 14, 2022
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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 6801106518 MI Primary

Addresses

Primary practice location

2222 S Linden Rd Ste J
Flint, MI 48532-5413

Mailing address

2550 S Telegraph Rd Ste 250
Bloomfield Hills, MI 48302-0909

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
I20220118001211 MI Practitioner - Clinical Social Worker 0143612408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801106518MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 8, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Apr 8, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Current Accepting new patients

Locations

2550 S Telegraph Rd
Ste 250
Bloomfld Hls, MI 48302
Phone (248) 322-0001

2222 S Linden Rd
Ste J
Flint, MI 48532
Phone (810) 720-5700

10785 S Saginaw St
Ste A
Grand Blanc, MI 48439
Phone (810) 695-0055

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, 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": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1033860614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S TELEGRAPH RD STE 250",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S LINDEN RD STE J",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325413",
            "telephone_number": "810-732-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMON",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "MSW, LMSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.