Active NPI
Connie Jeanne Cecil, LMSW
- Clinical Social Worker
- Saint Clair Shores, MI
National Provider Identifier
1154447670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6301011985
- Practice address
- 25401 Harper Ave
Saint Clair Shores, MI 48081-2240 - Phone
- (586) 466-6612
- Fax
- (586) 466-6961
- NPI assigned
- Mar 22, 2007
- 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 | 6301011985 | MI | Primary |
Addresses
Primary practice location
25401 Harper Ave
Saint Clair Shores, MI 48081-2240
Mailing address
407 Wilcox St
Rochester, MI 48307-1950
Phone (248) 709-4377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6301011985 | Other | MI | SOCIAL WORK LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6301011985 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Macomb Family Services, Inc. | Clinical | Past | Accepting new patients |
| Macomb Family Services, Inc | Clinical | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/macombfamily/r4/
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154447670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 WILCOX ST",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483071950",
"telephone_number": "248-709-4377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25401 HARPER AVE",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480812240",
"telephone_number": "586-466-6612",
"fax_number": "586-466-6961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CECIL",
"first_name": "CONNIE",
"middle_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6301011985",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK LICENSE",
"identifier": "6301011985",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.