Letisha Mechell Holloway, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091723 Issued in MI

Practice address

5031 Park Lake Rd
East Lansing, MI 48823-3835

Phone

(517) 332-0811

Fax

(517) 332-4452

NPI assigned

Sep 14, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Letisha Mechell Norris-Powell Former name

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meridian Professional Psychological ConsultantsGroup PAC ID 5193880284, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Meridian Professional Psychological Consultants

  • Psychiatry Physician
  • East Lansing, MI
  • NPI 1225150139
  Medicare reassignment Care Compare group NPD
• Professional Psychological & Rehabilitation Services

  • Clinical Psychologist
  • Lansing, MI
  • NPI 1972625424
  NPD (past)
• Professional Psychological and Rehabilitation Services, PC

  • Community/Behavioral Health Agency
  • Lansing, MI
  • NPI 1184021834
  NPD (past)

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1043592181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 NORBURN WAY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489116040",
            "telephone_number": "517-332-0811",
            "fax_number": "517-332-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 PARK LAKE RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233835",
            "telephone_number": "517-332-0811",
            "fax_number": "517-332-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "LETISHA",
        "middle_name": "MECHELL",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETISHA",
            "last_name": "NORRIS-POWELL",
            "middle_name": "MECHELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Joy Holesinger
• Richard Samuel Holland, R.PH., PH.D.,D.PH.
• Rachel Michelle Hollander
• Jennasee Hollingworth
• Zion Hollis
• Alyse Marie Holt-Briggs
• Sharon Renelee Holt, MHS, OTR, CBIS
• Gregory Scott Holzman, M.D.
• Home Care Kimistry LLC
• Charles Chansik Hong, MD PHD

• Clinical Social Worker in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.