Individual provider Active NPI

Rachel Danielle Warren, LLMSW

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1174073076
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801100355 Issued in MI
Practice address
5024 N Royal Dr Ste B
Traverse City, MI 49684
Phone
(231) 632-4490
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2018

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 6801100355 MI Primary

Addresses

Primary practice location

5024 N Royal Dr Ste B
Traverse City, MI 49684

Mailing address

5024 N Royal Dr Ste B
Traverse City, MI 49684-9230
Phone (231) 632-4490

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
I20191106000966 MI Practitioner - Clinical Social Worker 4284966540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801100355MIMDClinical Social Worker

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": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1174073076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 N ROYAL DR STE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849230",
            "telephone_number": "231-632-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5024 N ROYAL DR STE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-632-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "RACHEL",
        "middle_name": "DANIELLE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.