Individual provider Active NPI

Patricia J Tikkanen, LMSW

  • Social Worker
  • Hancock, MI
National Provider Identifier
1114951829
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801064290 Issued in MI
Practice address
200 Michigan St Ste 321
Hancock, MI 49930
Phone
(906) 369-5722
Fax
(906) 323-4212
NPI assigned
Jul 10, 2006
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801064290 MI Primary

Addresses

Primary practice location

200 Michigan St Ste 321
Hancock, MI 49930

Mailing address

200 Michigan St Ste 321
Hancock, MI 49930-1448
Phone (906) 369-5722

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
I20060906000432 MI Practitioner - Clinical Social Worker 5294739223 Practice locations: Hancock, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 Michigan St
Suite 321
Hancock, MI 49930-1448
Phone (906) 369-5722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801064290MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1114951829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MICHIGAN ST STE 321",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301448",
            "telephone_number": "906-369-5722",
            "fax_number": "906-323-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MICHIGAN ST STE 321",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "49930",
            "telephone_number": "906-369-5722",
            "fax_number": "906-323-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIKKANEN",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801064290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.