Individual provider Active NPI

Lynn Fonacier

  • Clinical Social Worker
  • Macomb, MI
National Provider Identifier
1083303416
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801082221 Issued in MI
Practice address
17832 Riverhill Dr
Macomb, MI 48044-2780
Phone
(586) 871-5012
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

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 6801082221 MI Primary

Addresses

Primary practice location

17832 Riverhill Dr
Macomb, MI 48044-2780

Mailing address

17832 Riverhill Dr
Macomb, MI 48044-2780
Phone (586) 871-5012

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
I20250617002242 MI Practitioner - Clinical Social Worker 3678084506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tree of Life Counseling Services LLCGroup PAC ID 4082156856, 24 clinicians

Practice addresses (Care Compare)

1460 Walton Blvd
Suite 60
Rochester Hills, MI 48309-1729
Phone (248) 608-4514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801082221MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tree of Life Counseling Services LLC CurrentSince Apr 9, 2025 Accepting new patients
Michael S Salter DPM PC CurrentSince Apr 9, 2025 Accepting new patients

Locations

1460 Walton Blvd
Ste 60
Rochester Hills, MI 48309
Phone (248) 651-0653

Organizations & group practices 2

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1083303416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17832 RIVERHILL DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442780",
            "telephone_number": "586-871-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17832 RIVERHILL DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442780",
            "telephone_number": "586-871-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONACIER",
        "first_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801082221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

Verify at the official NPI Registry.