Jacqueline Lee Konley, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801095263 Issued in MI

Practice address

10315 Grand River Rd Ste 302
Brighton, MI 48116-9586

Phone

(734) 657-8059

NPI assigned

Mar 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Living PLLCGroup PAC ID 6709914690, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Mindful Living PLLC

  • Psychologist
  • Brighton, MI
  • NPI 1013145879
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1093247702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3794 CORDLEY LAKE RD",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481698443",
            "telephone_number": "517-404-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 GRAND RIVER RD STE 302",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169586",
            "telephone_number": "734-657-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONLEY",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Ann Knittle, PA-C
• June Ko
• Ellen I Koch, PHD
• Debbie Koeltzow, EDD, LP
• Carly Komaromi
• Kor Chiro Studio PLLC
• Siddhika B Kore, PT
• Rebecca Moolayil Korpal, DO
• Steven T. Korycinski, MD
• Aimee Nicole Kotrba, PH.D.

• Clinical Social Worker in Brighton, MI
• Providers in Brighton, 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 9, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.