Individual provider Active NPI

Lenna Raskolnikov, LMSW ACSW

  • Clinical Social Worker
  • East Lansing, MI
National Provider Identifier
1124134986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801071212 Issued in MI
Practice address
4990 Northwind Dr
Suite 240
East Lansing, MI 48823-5090
Phone
(517) 853-2992
Fax
(517) 853-2993
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801071212 MI Primary

Addresses

Primary practice location

4990 Northwind Dr
Suite 240
East Lansing, MI 48823-5090

Mailing address

PO Box 23113
Suite 214
Lansing, MI 48909-3113
Phone (517) 853-2992

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801071212MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Counseling Services LLC Clinical PastSince Jan 1, 2007 Accepting new patients
Mareck Family and Geriatric Services, P.C. Clinical Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124134986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23113",
            "address_2": "SUITE 214",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489093113",
            "telephone_number": "517-853-2992",
            "fax_number": "517-853-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 NORTHWIND DR",
            "address_2": "SUITE 240",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235090",
            "telephone_number": "517-853-2992",
            "fax_number": "517-853-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKOLNIKOV",
        "first_name": "LENNA",
        "name_prefix": "Ms.",
        "credential": "LMSW ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801071212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.