Individual provider Active NPI

Jerri Lynn Stotz, LMSW, CAADC

  • Clinical Social Worker
  • Monroe, MI
National Provider Identifier
1124467568
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095539 Issued in MI
Practice address
25 S Monroe St
Monroe, MI 48161-2468
Phone
(734) 240-3850
Fax
(734) 240-3863
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801095539 MI
Clinical Social Worker 1041C0700X 6801095539 MI Primary

Addresses

Primary practice location

25 S Monroe St
Monroe, MI 48161-2468

Mailing address

25 S Monroe St Ste 205
Monroe, MI 48161-2469
Phone (734) 240-3850

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
I20180808000149 MI Practitioner - Clinical Social Worker 3577811553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choices Counseling Solutions LLCGroup PAC ID 9739548421, 6 clinicians

Practice addresses (Care Compare)

15366 S Dixie Hwy
Monroe, MI 48161-3773
Phone (734) 210-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095539MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Choices Counseling Solutions LLC CurrentSince Sep 7, 2023 Accepting new patients

Locations

15366 S Dixie Hwy
Monroe, MI 48161
Phone (734) 210-1071

Organizations & group practices 1

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1124467568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S MONROE ST STE 205",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612469",
            "telephone_number": "734-240-3850",
            "fax_number": "734-240-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612468",
            "telephone_number": "734-240-3850",
            "fax_number": "734-240-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTZ",
        "first_name": "JERRI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801095539",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.