Marissa Leeann Havard, LMSW- CLINICAL

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801114325 Issued in MI

Practice address

1701 Lake Lansing Rd Ste 120
Lansing, MI 48912-3798

Phone

(517) 882-3732

NPI assigned

Nov 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Barry University School of Podiatric Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1295866135

  Clinical

  Medicare reassignment Care Compare group NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130

  Clinical

  NPD

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1124738182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 LAKE LANSING RD STE 120",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123798",
            "telephone_number": "989-413-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LAKE LANSING RD STE 120",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123798",
            "telephone_number": "517-882-3732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10630 E Lansing Rd",
            "address_purpose": "LOCATION",
            "city": "Durand",
            "state": "MI",
            "postal_code": "484291811",
            "country_code": "US",
            "telephone_number": "989-413-4941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVARD",
        "first_name": "MARISSA",
        "middle_name": "LEEANN",
        "credential": "LMSW- CLINICAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6901114325",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark E Hatch, D.O.
• Autumn Hath
• Jason Kemuel Haugen, NP-C
• Jennifer Hauptman
• Gerald D Hause, DDS
• Anna Havener, RBT
• Havenwood Care of Michigan LLC
• Chris Adam Hawkins, D.C.
• Gertrude R. Hawkins, DO
• Heather Hawkins

• Clinical Social Worker in Lansing, MI
• Providers in Lansing, 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 Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.