Active NPI
Elizabeth Mary Black, LLMSW
- Social Worker
- Midland, MI
National Provider Identifier
1053010868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6851115185
- Practice address
- 3007 N Saginaw Rd
Midland, MI 48640-4555 - Phone
- (989) 839-3538
- Fax
- (989) 899-7247
- NPI assigned
- Mar 1, 2023
- Last updated
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6851115185 | MI | Primary |
Addresses
Primary practice location
3007 N Saginaw Rd
Midland, MI 48640-4555
Mailing address
3007 N Saginaw Rd
Midland, MI 48640-4555
Phone (989) 839-3538
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3007 N Saginaw Rd
Mymichigan Psychiatry
Midland, MI 48640-4555
Phone (989) 839-3385
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851115185 | MI | MD | Social Worker |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Midland, MI
- NPI 1205889490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677628800000",
"number": "1053010868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3007 N SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486404555",
"telephone_number": "989-839-3538",
"fax_number": "989-799-7247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3007 N SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486404555",
"telephone_number": "989-839-3538",
"fax_number": "989-899-7247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "ELIZABETH",
"middle_name": "MARY",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-01",
"last_updated": "2023-03-01",
"certification_date": "2023-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6851115185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.