Individual provider Active NPI

Justin D Oh-Lee, LMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1205484227
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801105660 Issued in MI
Practice address
5816 Eastman Ave
Midland, MI 48640-6792
Phone
(989) 244-1888
Fax
(989) 321-6544
NPI assigned
Sep 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 6801105660 MI Primary

Addresses

Primary practice location

5816 Eastman Ave
Midland, MI 48640-6792

Mailing address

100 NB Gratiot Ave
Mount Clemens, MI 48043-2301
Phone (586) 783-2950

Other practice location 1

120 E Warwick Dr
Alma, MI 48801-1010
Phone (989) 463-2779

Other practice location 2

6030 Bay Rd
Saginaw, MI 48604-8703
Phone (989) 244-1888

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
I20240503002521 MI Practitioner - Clinical Social Worker 4981044104 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801105660MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Psychiatric & Counseling Center, PC Clinical CurrentSince Apr 1, 2024 Accepting new patients
Renewal Christian Counseling Inc Clinical CurrentSince Sep 8, 2019 Accepting new patients
Healthy Transitions LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

120 E Warwick Dr
Alma, MI 48801
Phone (989) 463-2779

5816 Eastman Ave
Midland, MI 48640
Phone (989) 244-1888

6030 Bay Rd
Saginaw, MI 48604
Phone (989) 244-1888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24246/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1205484227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NB GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432301",
            "telephone_number": "586-783-2950",
            "fax_number": "586-690-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 EASTMAN AVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406792",
            "telephone_number": "989-244-1888",
            "fax_number": "989-321-6544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 E Warwick Dr",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "MI",
            "postal_code": "488011010",
            "country_code": "US",
            "telephone_number": "989-463-2779",
            "fax_number": "989-463-2064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6030 Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486048703",
            "country_code": "US",
            "telephone_number": "989-244-1888",
            "fax_number": "989-321-6544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OH-LEE",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.