Tatyana Fleysher, MSW

Individual provider Active NPI Clinical Social Worker · Owosso, MI

NPI 1114285392 · NPPES record last updated Apr 29, 2019

Key facts

NPI
1114285392
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801093147 (MI)
Practice address
1555 Industrial Dr
Owosso, MI 48867-9775
Phone
(989) 723-6791
NPI assigned
Apr 25, 2012
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PC (289 clinicians)

Practice addresses (Care Compare)

1100 Torrey Rd
Suite 100
Fenton, MI 48430-3327
Phone (810) 494-7180

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190520000017 MI Practitioner - Clinical Social Worker 0941548507 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical Current
since May 8, 2023
Accepting new patients
Downriver Mental Health Clinic PC Clinical Current
since May 8, 2023
Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

1100 Torrey Rd
Ste 100
Fenton, MI 48430
Phone 8104947180106

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801093147 MI Yes

Addresses

Primary practice location

1555 Industrial Dr
Owosso, MI 48867-9775

Mailing address

PO Box 428
Owosso, MI 48867-0428

Other providers in Owosso, MI

All providers in Owosso, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.