Individual provider Active NPI

Tatyana Fleysher, MSW

  • Clinical Social Worker
  • Owosso, MI
National Provider Identifier
1114285392
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093147 Issued in MI
Practice address
1555 Industrial Dr
Owosso, MI 48867-9775
Phone
(989) 723-6791
NPI assigned
Apr 25, 2012
Last updated
Apr 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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 6801093147 MI Primary

Addresses

Primary practice location

1555 Industrial Dr
Owosso, MI 48867-9775

Mailing address

PO Box 428
Owosso, MI 48867-0428

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
I20190520000017 MI Practitioner - Clinical Social Worker 0941548507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093147MIMDClinical Social Worker

Practice roles

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1114285392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488670428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 INDUSTRIAL DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679775",
            "telephone_number": "989-723-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEYSHER",
        "first_name": "TATYANA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.