Active NPI
Susan Mahalik, MSW
- Clinical Social Worker
- Wyandotte, MI
National Provider Identifier
1154434959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801078886
- Practice address
- 2514 Biddle Ave
Wyandotte, MI 48192-7891 - Phone
- (517) 775-4248
- Fax
- (734) 282-2215
- NPI assigned
- Aug 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801078886 | MI | Primary |
Addresses
Primary practice location
2514 Biddle Ave
Wyandotte, MI 48192-7891
Mailing address
13465 Strathcona Avenue
Apt. 209
Southgate, MI 48195
Phone (734) 282-2215
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0899332 | Other | MI | BCBSM PROVIDER PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801078886 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Mental Health Clinic PC | Clinical | Past | Accepting new patients |
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": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443052800000",
"number": "1154434959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13465 STRATHCONA AVENUE",
"address_2": "APT. 209",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "48195",
"telephone_number": "734-282-2215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2514 BIDDLE AVE",
"city": "WYANDOTTE",
"state": "MI",
"postal_code": "481927891",
"telephone_number": "517-775-4248",
"fax_number": "734-282-2215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHALIK",
"first_name": "SUSAN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2015-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801078886",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM PROVIDER PIN",
"identifier": "0899332",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyandotte, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.