Individual provider Active NPI

Lisa Yvette Ottenhoff, LMSW, ACSW

  • Clinical Social Worker
  • Battle Creek, MI
National Provider Identifier
1083613624
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801065659 Issued in MI
Practice address
391 S Shore Dr Ste 214
Battle Creek, MI 49014-5446
Phone
(269) 964-0153
Fax
(855) 877-5812
NPI assigned
Jul 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 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 6801065659 MI Primary

Addresses

Primary practice location

391 S Shore Dr Ste 214
Battle Creek, MI 49014-5446

Mailing address

391 S Shore Dr Ste 214
Battle Creek, MI 49014-5446
Phone (269) 964-0153

Other identifiers 1

IdentifierTypeStateIssuer
MI3674OtherMIMEDICARE PTAN

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
I20110118000994 MI Practitioner - Clinical Social Worker 9234328584 Reassigns benefits to 1 organization
Practice locations: Battle Creek, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Comforts of Home Counseling and Care Management LLCGroup PAC ID 8123305802, 11 clinicians

Practice addresses (Care Compare)

391 S Shore Dr
Suite 214
Battle Creek, MI 49014-5446
Phone (269) 964-0153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comforts of Home Counseling & Care Management LLC Clinical CurrentSince Mar 5, 2017 Accepting new patients

Locations

391 S Shore Dr
Ste 214
Battle Creek, MI 49014
Phone (269) 245-5440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1083613624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 S SHORE DR STE 214",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145446",
            "telephone_number": "269-964-0153",
            "fax_number": "855-877-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 S SHORE DR STE 214",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145446",
            "telephone_number": "269-964-0153",
            "fax_number": "855-877-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENHOFF",
        "first_name": "LISA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-16",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801065659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MI3674",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.