Individual provider Active NPI

Andrea N Scott, MSW

  • School Social Worker
  • Three Rivers, MI
National Provider Identifier
1063845139
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
6801106479 Issued in MI
Practice address
1101 Jefferson St
Three Rivers, MI 49093-1024
Phone
(269) 279-1130
Fax
(269) 273-1139
NPI assigned
Aug 13, 2013
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801095870 MI
School Social Worker 1041S0200X 6801106479 MI Primary

Addresses

Primary practice location

1101 Jefferson St
Three Rivers, MI 49093-1024

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

721 6th Ave Ste A
Three Rivers, MI 49093-8378
Phone (269) 273-1418

Other identifiers 1

IdentifierTypeStateIssuer
1063845139MedicaidMI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095870MIMDClinical Social Worker
6801106479MIMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Health System, Inc School CurrentSince Feb 6, 2020 Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

1101 Jefferson St
Three Rivers, MI 49093
Phone (269) 279-1130

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.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1063845139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JEFFERSON ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490931024",
            "telephone_number": "269-279-1130",
            "fax_number": "269-273-1139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 6th Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490938378",
            "country_code": "US",
            "telephone_number": "269-273-1418",
            "fax_number": "269-273-3347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ANDREA",
        "middle_name": "N",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095870",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "6801106479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063845139",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.