Individual provider Active NPI

Adam Anderson

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1124775994
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851116484 Issued in MI
Practice address
4925 Packard St
Ann Arbor, MI 48108-1521
Phone
(734) 971-9781
NPI assigned
Mar 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851116484 MI Primary

Addresses

Primary practice location

4925 Packard St
Ann Arbor, MI 48108-1521

Mailing address

4925 Packard St
Ann Arbor, MI 48108-1521
Phone (734) 971-9781

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

LicenseStateTypeSpecialty
6851116484MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Social Services of Washtenaw County CurrentSince Mar 11, 2025 Accepting new patients
All Well-Being Services PastSince Mar 1, 2022 Accepting new patients
Adult Well Being Services PastSince Mar 1, 2022 Accepting new patients

Locations

4925 Packard St
Ann Arbor, MI 48108
Phone (734) 971-9781

Organizations & group practices 3

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1124775994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-02",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851116484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.