Individual provider Active NPI

Janet Lynn Vizina-Roubal, LMSW

  • Clinical Social Worker
  • Big Rapids, MI
National Provider Identifier
1154404838
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085175 Issued in MI
Practice address
500 S 3Rd Ave
Big Rapids, MI 49307-9501
Phone
(231) 796-5825
Fax
(231) 796-2178
NPI assigned
Oct 24, 2006
Last updated
Apr 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801085175 MI Primary

Addresses

Primary practice location

500 S 3Rd Ave
Big Rapids, MI 49307-9501

Mailing address

3298 Veterans Dr
Traverse City, MI 49684-4725
Phone (231) 715-8466

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801085175MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Clinical PastSince Mar 22, 2016 Accepting new patients
Community Mental Health for Central Michigan Clinical Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1154404838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3298 VETERANS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844725",
            "telephone_number": "231-715-8466",
            "fax_number": "231-943-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 3RD AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493079501",
            "telephone_number": "231-796-5825",
            "fax_number": "231-796-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZINA-ROUBAL",
        "first_name": "JANET",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.