Katie Janisse, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087426 Issued in MI

Practice address

135 Broadway St
Marine City, MI 48039-1607

Phone

(810) 765-5010

NPI assigned

Nov 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1124329255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BROADWAY ST",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480391607",
            "telephone_number": "810-765-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BROADWAY ST",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480391607",
            "telephone_number": "810-765-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1570 Suncrest Dr",
            "address_purpose": "LOCATION",
            "city": "Lapeer",
            "state": "MI",
            "postal_code": "484461154",
            "country_code": "US",
            "telephone_number": "810-667-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANISSE",
        "first_name": "KATIE",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Marine City, MI
• Providers in Marine City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.