Individual provider Active NPI

Stephanie Rudlaff, LMSW

  • Social Worker
  • Lansing, MI
National Provider Identifier
1154710879
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094564 Issued in MI
Practice address
2535 E Mount Hope Ave
Lansing, MI 48910-1913
Phone
(517) 372-2535
NPI assigned
Jan 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094564 MI
Social Worker 104100000X 6801094564 MI Primary

Addresses

Primary practice location

2535 E Mount Hope Ave
Lansing, MI 48910-1913

Mailing address

PO Box 10
Mason, MI 48854-0010

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
I20170127002418 MI Practitioner - Clinical Social Worker 0042592966 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094564MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DBT Center of Michigan, LLC Clinical CurrentSince Dec 27, 2016 Accepting new patients
Mindful Therapy Services LLC Social Worker CurrentSince Feb 15, 2017 Accepting new patients
DBT Institute of Mi PastSince May 12, 2024 Accepting new patients

Locations

4205 Charlar Dr
Ste 3
Holt, MI 48842
Phone (517) 214-7964

2535 E Mount Hope Ave
Lansing, MI 48910
Phone (517) 372-2535

Organizations & group practices 4

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": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1154710879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489101913",
            "telephone_number": "517-372-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDLAFF",
        "first_name": "STEPHANIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094564",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.