Kristin Penix, LMSW

Individual provider Active NPI Social Worker · Clarkston, MI

NPI 1124416979 · NPPES record last updated Nov 15, 2023

Key facts

NPI
1124416979
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
6801094044 (MI)
Practice address
6548 Town Center Dr
Clarkston, MI 48346-4823
Phone
(248) 663-4338
NPI assigned
Jan 2, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richard Kneip PHD PC (243 clinicians)

Practice addresses (Care Compare)

6548 Town Ctr Dr
Suite D
Clarkston, MI 48346-4823
Phone (800) 693-1916

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150108000610 MI Practitioner - Clinical Social Worker 1759604283 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6801094044MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. Current
since Oct 26, 2023
Accepting new patients
Arbor West Chiropractic Center P.C. Past Accepting new patients

Locations

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094044 MI
Social Worker 104100000X 6801094044 MI Yes

Addresses

Primary practice location

6548 Town Center Dr
Clarkston, MI 48346-4823

Mailing address

PO Box 772263
Detroit, MI 48277-2263
Phone (248) 453-7525

Other providers in Clarkston, MI

All providers in Clarkston, MI · Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.