Individual provider Active NPI

Laural Lee Pond, MT-BC, DP

  • Clinical Social Worker
  • Negaunee, MI
National Provider Identifier
1114445129
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851110741 Issued in MI
Practice address
104 Malton Rd
Negaunee, MI 49866-2000
Phone
(906) 228-4692
Fax
(906) 228-2830
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Music Therapist 225A00000X OR
Clinical Social Worker 1041C0700X 6851110741 MI Primary

Addresses

Primary practice location

104 Malton Rd
Negaunee, MI 49866-2000

Mailing address

1209 N 3Rd St
Marquette, MI 49855-3009
Phone (906) 273-0964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851110741MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Suunta Integrative Health Clinical CurrentSince Mar 31, 2024 Accepting new patients
Great Lakes Recovery Centers Past Accepting new patients
Great Lakes Recovery Centers Past Accepting new patients

Locations

1209 N 3rd St
Marquette, MI 49855
Phone (906) 273-0964

Organizations & group practices 3

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": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1114445129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 N 3RD ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553009",
            "telephone_number": "906-273-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MALTON RD",
            "city": "NEGAUNEE",
            "state": "MI",
            "postal_code": "498662000",
            "telephone_number": "906-228-4692",
            "fax_number": "906-228-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "LAURAL",
        "middle_name": "LEE",
        "credential": "MT-BC, DP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851110741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Negaunee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.