Individual provider Active NPI

Joan Earl McDevitt, LMSW/CQMHP

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1083190805
Registry record updated Jul 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085492 Issued in MI
Practice address
2126 Tamie Way
Jackson, MI 49203-3626
Phone
(517) 745-2458
NPI assigned
Jul 15, 2018
Last updated
Jul 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2018

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 6801085492 MI Primary

Addresses

Primary practice location

2126 Tamie Way
Jackson, MI 49203-3626

Mailing address

2126 Tamie Way
Jackson, MI 49203-3626
Phone (517) 745-2458

Other identifiers 1

IdentifierTypeStateIssuer
6801085492OtherMIMASTER'S SOCIAL WORKER LICENSE-CLINICAL LICENSE

Other names 1

  • Joan E McDevitt Professional name

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
I20210406002166 MI Practitioner - Clinical Social Worker 0446667638 Practice locations: Jackson, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7101 Browns Lake Rd
Jackson, MI 49201-8332
Phone (517) 745-2458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801085492MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Counseling of Jackson Clinical PastSince Sep 5, 2023 Accepting new patients

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": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531612800000",
    "number": "1083190805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 TAMIE WAY",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033626",
            "telephone_number": "517-745-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 TAMIE WAY",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033626",
            "telephone_number": "517-745-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDEVITT",
        "first_name": "JOAN",
        "middle_name": "EARL",
        "credential": "LMSW/CQMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2018-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTER'S SOCIAL WORKER LICENSE-CLINICAL LICENSE",
            "identifier": "6801085492",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "MCDEVITT",
            "middle_name": "E",
            "credential": "LMSW/CQMHP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.