Active NPI
Maria Kloeckner, LLMSW
- Clinical Social Worker
- Jackson, MI
National Provider Identifier
1124529151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801100688
- Practice address
- 330 W Michigan Ave
Jackson, MI 49201-2121 - Phone
- (517) 787-7920
- NPI assigned
- Feb 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801100688 | MI | Primary |
Addresses
Primary practice location
330 W Michigan Ave
Jackson, MI 49201-2121
Mailing address
330 W Michigan Ave
Jackson, MI 49201-2121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6801100688 | Other | MI | LIMITED LICENSE MASTER SOCIAL WORKER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801100688 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1124529151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 W MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 W MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012121",
"telephone_number": "517-787-7920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOECKNER",
"first_name": "MARIA",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-25",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801100688",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIMITED LICENSE MASTER SOCIAL WORKER",
"identifier": "6801100688",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.