Individual provider Active NPI

Carol Jane Deering, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1063835387
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801065806 Issued in MI
Practice address
1945 Pauline Blvd
Suite 10
Ann Arbor, MI 48103
Phone
(734) 730-4184
NPI assigned
Jan 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801065806 MI Primary

Addresses

Primary practice location

1945 Pauline Blvd
Suite 10
Ann Arbor, MI 48103

Mailing address

6542 Foothill Drive
Ypsilanti, MI 48197-4536
Phone (734) 730-4184

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
I20140408000544 MI Practitioner - Clinical Social Worker 4981836871 Reassigns benefits to 1 organization
Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Family Psychiatry PLCGroup PAC ID 7012985237, 10 clinicians

Practice addresses (Care Compare)

1235 Industrial Dr
Suite 4
Saline, MI 48176-1742
Phone (734) 944-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801065806MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen Diehl LMSW LLC CurrentSince May 19, 2024 Accepting new patients
Center for Family Psychiatry, PLC Clinical CurrentSince Mar 1, 2014 Accepting new patients
Kristin Blackburn LMSW PLLC CurrentSince Feb 23, 2025 Accepting new patients
Center for Family Psychiatry, PLC Clinical CurrentSince Mar 1, 2014 Accepting new patients

Locations

1945 Pauline Blvd
Ste 10
Ann Arbor, MI 48103
Phone (734) 476-0528

1235 Industrial Dr
Ste 4
Saline, MI 48176
Phone (734) 944-8300

1235 Industrial Dr
Saline, MI 48176
Phone (734) 263-9276

Organizations & group practices 4

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": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1063835387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6542 FOOTHILL DRIVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974536",
            "telephone_number": "734-730-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 PAULINE BLVD",
            "address_2": "SUITE 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48103",
            "telephone_number": "734-730-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERING",
        "first_name": "CAROL",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801065806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.