Individual provider Active NPI

Jill Kind, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1043832173
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801076789 Issued in MI
Practice address
2245 S State St Ste 200
Ann Arbor, MI 48104-6184
Phone
(734) 769-0209
Fax
(734) 769-0224
NPI assigned
May 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801076789 MI Primary

Addresses

Primary practice location

2245 S State St Ste 200
Ann Arbor, MI 48104-6184

Mailing address

2245 S State St Ste 200
Ann Arbor, MI 48104-6184
Phone (734) 769-0209

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
I20200515000242 MI Practitioner - Clinical Social Worker 9335570936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jewish Family Services of Washtenaw County IncGroup PAC ID 2769671106, 8 clinicians

Practice addresses (Care Compare)

2245 S State St
Suite 200
Ann Arbor, MI 48104-6184
Phone (734) 769-0209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801076789MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Services of Washtenaw County, Inc. Clinical CurrentSince May 13, 2020 Accepting new patients

Locations

2245 S State St
Ste 200
Ann Arbor, MI 48104
Phone (734) 769-0209

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": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1043832173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 S STATE ST STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046184",
            "telephone_number": "734-769-0209",
            "fax_number": "734-769-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 S STATE ST STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046184",
            "telephone_number": "734-769-0209",
            "fax_number": "734-769-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIND",
        "first_name": "JILL",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801076789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.