Organization Active NPI

Carol Diane Psaila

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1144769050
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801077434 Issued in MI
Legal business name
CAROL DIANE PSAILA
Practice address
3830 Packard St Ste 250
Ann Arbor, MI 48108-2273
Phone
(734) 358-3810
NPI assigned
Feb 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Carol D Psaila, LMSWNPI 1356462360
Title
LMSW
Phone
(734) 358-3810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801077434 MI Primary

Addresses

Primary practice location

3830 Packard St Ste 250
Ann Arbor, MI 48108-2273

Mailing address

7618 Bay Tree Dr
Ypsilanti, MI 48197-9572
Phone (734) 358-3810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170307000476 MI Part B Supplier - Clinic/Group Practice 8123302353 Receives reassigned benefits from 1 practitioner
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

3820 Packard St
Ste 160
Ann Arbor, MI 48108
Phone (734) 358-3810

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1144769050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7618 BAY TREE DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979572",
            "telephone_number": "734-358-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 PACKARD ST STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082273",
            "telephone_number": "734-358-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL DIANE PSAILA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "PSAILA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "LMSW",
        "authorized_official_telephone_number": "734-358-3810",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077434",
            "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 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.