Individual provider Active NPI

Tamara Sue Edinger, LMSW, ACSW

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1073688784
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081945 Issued in MI
Practice address
915 Airport Rd
Jackson, MI 49202-1872
Phone
(517) 937-5570
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801081945 MI
Clinical Social Worker 1041C0700X 6801081945 MI Primary

Addresses

Primary practice location

915 Airport Rd
Jackson, MI 49202-1872

Mailing address

PO Box 271
Jackson, MI 49204-0271

Other practice location 1

1220 White Lake Rd
Pleasant Lake, MI 49272-9625
Phone (517) 937-5570

Other identifiers 6

IdentifierTypeStateIssuer
AETNAOtherMI7554568
19416MedicaidMI
579118000OtherMIMAGELLAN
240366OtherMICOMPSYCH
CARE CHOICESOtherMI138623
8008921080OtherMIBCBSMI

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
I20051207000820 MI Practitioner - Clinical Social Worker 3173544012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1220 White Lake Rd
Pleasant Lake, MI 49272-9625
Phone (517) 937-5570

915 Airport Rd
Jackson, MI 49202-1872
Phone (517) 937-5570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801081945MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Gallagher LMSW Acsw Professional Counseling SRVS LLC Clinical CurrentSince Jun 17, 2017 Accepting new patients
Tammy Edinger LLC Social Worker CurrentSince Feb 1, 2019 Accepting new patients
Lake House Counseling PLLC Social Worker Past Accepting new patients

Locations

3210 E Lake Lansing Rd
East Lansing, MI 48823
Phone (517) 862-9389

915 Airport Rd
Jackson, MI 49202
Phone (517) 206-3016

2149 Jolly Rd
Ste 500
Okemos, MI 48864
Phone 5173474645102

Organizations & group practices 3

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1073688784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492040271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 AIRPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021872",
            "telephone_number": "517-937-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 White Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Pleasant Lake",
            "state": "MI",
            "postal_code": "492729625",
            "country_code": "US",
            "telephone_number": "517-937-5570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDINGER",
        "first_name": "TAMARA",
        "middle_name": "SUE",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801081945",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "7554568",
            "identifier": "AETNA",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19416",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "579118000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "240366",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "138623",
            "identifier": "CARE CHOICES",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI",
            "identifier": "8008921080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.