Individual provider Active NPI

Stacy M Linihan, LMSW

  • Clinical Social Worker
  • Centreville, MI
National Provider Identifier
1174600522
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088334 Issued in MI
Practice address
658 East Main
Centreville, MI 49032
Phone
(269) 467-3228
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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 6801088334 MI Primary

Addresses

Primary practice location

658 East Main
Centreville, MI 49032

Mailing address

658 East Main
Centreville, MI 49032
Phone (269) 467-3228

Other identifiers 1

IdentifierTypeStateIssuer
1708146MedicaidMI

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
I20170602001032 MI Practitioner - Clinical Social Worker 2163799750 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Covered Bridge Healthcare of St. Joseph County Inc CurrentSince May 1, 2016 Accepting new patients

Locations

658 E Main St
Centreville, MI 49032
Phone (269) 467-3228

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABDFAD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Covered Bridge Healthcare of St. Joseph County IncCentreville, MI, CCN 231096 Federally qualified health center Corporate Director
W-2 Managing Employee
May 1, 2016
May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1174600522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 EAST MAIN",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "49032",
            "telephone_number": "269-467-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 EAST MAIN",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "49032",
            "telephone_number": "269-467-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINIHAN",
        "first_name": "STACY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1708146",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MI

Sources for this page

Verify at the official NPI Registry.