Jason Michael Gilliam, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801096929 Issued in MI

Practice address

12990 Ontonagon Dr
Dewitt, MI 48820-8658

Phone

(517) 202-3022

NPI assigned

Sep 11, 2009

Last updated

Nov 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Community Mental Health Authority Clinton Eaton Ingham Counties

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lansing, MI
  • NPI 1265483457
  Medicare reassignment NPD
• DBT Center of Michigan, LLC

  • Clinical Social Worker
  • Holt, MI
  • NPI 1710114707
  NPD
• DBT Institute of Mi

  dba DBT Institute of Michigan

  • Community/Behavioral Health Agency
  • Mason, MI
  • NPI 1992552905
  NPD (past)

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1083947832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12990 ONTONAGON DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208658",
            "telephone_number": "517-202-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 ONTONAGON DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208658",
            "telephone_number": "517-202-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 E Jolly Rd Ste 311",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489106825",
            "country_code": "US",
            "telephone_number": "517-346-8318",
            "fax_number": "517-346-8420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-11",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Joseph Fedewa, D.M.D.
• Mary Margaret Fedewa, CRNP CNS
• Jana Marie Fisher, O.D.
• Emily Anne Fritz
• Jaren Marie Pickens Gebhard, PT
• Kaylea Sayle Goerge-Flowers
• Alberto Gomez, OD
• Peter Timothy Graham, MD
• Faith June-Marie Gray, MA, CF-SLP
• Great Lakes Family Dental Group-Dewitt, P.C.

• Clinical Social Worker in Dewitt, MI
• Providers in Dewitt, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.