Robert E Ennis Sr., LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6801010482 Issued in MI

Practice address

129 E 3Rd St
Flint, MI 48502-1728

Phone

(810) 233-4031

Fax

(810) 237-4141

NPI assigned

Aug 29, 2011

Last updated

Aug 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

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, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mkaddesh Enterprises LLCGroup PAC ID 6901130483, 3 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.

• Mkaddesh Enterprises LLC

  dba Goals For My Life

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1518664069

  Professional

  Medicare reassignment Care Compare group NPD
• Ennis Center for Children, Inc

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1689098121
  NPD (past) Authorized official
• Ennis Center for Children, Inc.

  • Community/Behavioral Health Agency
  • Flint, MI
  • NPI 1851520589
  Authorized official Same address or phone
• Ennis Center for Children, Inc

  • Clinical Social Worker
  • Pontiac, MI
  • NPI 1104244953
  NPD (past)

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1063793594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12190 SILVER LAKE RD",
            "city": "BYRON",
            "state": "MI",
            "postal_code": "484189001",
            "telephone_number": "810-233-4031",
            "fax_number": "810-237-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E 3RD ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021728",
            "telephone_number": "810-233-4031",
            "fax_number": "810-237-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_suffix": "Sr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6801010482",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801010482",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801010482",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6801010482",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "6801010482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph English
• Enhanced Chiropractic PLLC
• Ennis Center for Children
• Ennis Center for Children, Inc.
• Anthony Ennis, LLPC
• Marie Enright
• Susan Enright, DO
• Catherine Therese Ensworth, AGNP-C, PMHNP-BC
• Envision Diagnostic Ultrasound Imaging LLC
• Envoy Health Management, LLC

• Mental Health Counselor in Flint, MI
• Providers in Flint, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.