Individual provider Active NPI

Maureen McCloskey, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1164809992
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801106413 Issued in MI
Practice address
4925 Packard St
Ann Arbor, MI 48108-1521
Phone
(734) 971-9781
Fax
(734) 971-2730
NPI assigned
Apr 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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 6801092572 MI
Clinical Social Worker 1041C0700X 6801106413 MI Primary

Addresses

Primary practice location

4925 Packard St
Ann Arbor, MI 48108-1521

Mailing address

4925 Packard St
Ann Arbor, MI 48108-1521
Phone (734) 971-9781

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
6801092572MIMDClinical Social Worker
6801106413MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1164809992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781",
            "fax_number": "734-971-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781",
            "fax_number": "734-971-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOSKEY",
        "first_name": "MAUREEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092572",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.