Individual provider Active NPI

Susan Rohde, MSW

  • Clinical Social Worker
  • Davisburg, MI
National Provider Identifier
1043370455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6802083532 Issued in MI
Practice address
12850 Fountain SQ
Ste. 106
Davisburg, MI 48350-2552
Phone
(248) 634-6303
Fax
(248) 634-1746
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6802083532 MI Primary

Addresses

Primary practice location

12850 Fountain SQ
Ste. 106
Davisburg, MI 48350-2552

Mailing address

12850 Fountain SQ
Ste. 106
Davisburg, MI 48350-2552
Phone (248) 634-6303

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
I20090528000234 MI Practitioner - Clinical Social Worker 8729137534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

24715 Little Mack Ave
Suite 200
Saint Clair Shores, MI 48080-3207
Phone (586) 777-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802083532MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Mental Health Current Accepting new patients

Locations

24715 Little Mack Ave
Ste 200
St Clr Shores, MI 48080
Phone (586) 777-9000

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.susanrohde@150339.advancedmd-direct.com

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043370455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12850 FOUNTAIN SQ",
            "address_2": "STE. 106",
            "city": "DAVISBURG",
            "state": "MI",
            "postal_code": "483502552",
            "telephone_number": "248-634-6303",
            "fax_number": "248-634-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12850 FOUNTAIN SQ",
            "address_2": "STE. 106",
            "city": "DAVISBURG",
            "state": "MI",
            "postal_code": "483502552",
            "telephone_number": "248-634-6303",
            "fax_number": "248-634-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHDE",
        "first_name": "SUSAN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802083532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davisburg, MI

Sources for this page

Verify at the official NPI Registry.