Individual provider Active NPI

Mary Louise Schaub, LMSW

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1154419828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801078757 Issued in MI
Practice address
3180 Racquet Club Dr
Suite G
Traverse City, MI 49684-4797
Phone
(231) 922-2885
Fax
(231) 922-0135
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801078757 MI Primary

Addresses

Primary practice location

3180 Racquet Club Dr
Suite G
Traverse City, MI 49684-4797

Mailing address

450 Alice LN
Traverse City, MI 49684-8646
Phone (231) 943-3854

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050407000254 MI Practitioner - Clinical Social Worker 2466409818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adaptive Counseling and Case Management LLCGroup PAC ID 8921248139, 8 clinicians

Practice addresses (Care Compare)

3298 Veterans Dr
Traverse City, MI 49684-4725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801078757MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adaptive Counseling and Case Management, LLC Clinical CurrentSince Dec 1, 2016 Accepting new patients

Locations

3298 Veterans Dr
Traverse City, MI 49684
Phone (231) 715-1491

3298 Veterans Dr
Ste 1
Traverse City, MI 49684
Phone (231) 715-1491

Organizations & group practices 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154419828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 ALICE LN",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848646",
            "telephone_number": "231-943-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 RACQUET CLUB DR",
            "address_2": "SUITE G",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844797",
            "telephone_number": "231-922-2885",
            "fax_number": "231-922-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUB",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801078757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.