Individual provider Active NPI

Carissa Lynn Yeomans

  • Clinical Social Worker
  • Reed City, MI
National Provider Identifier
1043959315
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851115077 Issued in MI
Practice address
4473 220TH Ave
Reed City, MI 49677-8593
Phone
(231) 832-2247
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6851115077 MI Primary

Addresses

Primary practice location

4473 220TH Ave
Reed City, MI 49677-8593

Mailing address

107 N Kent St
Leroy, MI 49655-9701
Phone (231) 388-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851115077MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Clinical CurrentSince Jun 5, 2022 Accepting new patients
Community Mental Health for Central Michigan Clinical PastSince Jun 5, 2022 Accepting new patients

Locations

4473 220th Ave
Reed City, MI 49677
Phone (231) 832-2247

Organizations & group practices 2

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1043959315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N KENT ST",
            "city": "LEROY",
            "state": "MI",
            "postal_code": "496559701",
            "telephone_number": "231-388-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4473 220TH AVE",
            "city": "REED CITY",
            "state": "MI",
            "postal_code": "496778593",
            "telephone_number": "231-832-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEOMANS",
        "first_name": "CARISSA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851115077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reed City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.