Individual provider Active NPI

Jillian Cloutier, LMSW

  • Social Worker
  • Sterling Heights, MI
National Provider Identifier
1205553666
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801114758 Issued in MI
Practice address
38600 Van Dyke Ave Ste 101
Sterling Heights, MI 48312-1171
Phone
(248) 460-9421
NPI assigned
Oct 25, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801114758 MI Primary

Addresses

Primary practice location

38600 Van Dyke Ave Ste 101
Sterling Heights, MI 48312-1171

Mailing address

15894 Cambridge Dr
Clinton Township, MI 48038-1011
Phone (586) 441-8535

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
I20230306000421 MI Practitioner - Clinical Social Worker 5496128837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

38600 Van Dyke Ave
Suite 101
Sterling Heights, MI 48312-1171
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Feb 27, 2023 Accepting new patients

Locations

38600 Van Dyke Ave
Ste 101
Sterling Heights, MI 48312
Phone (248) 460-9421

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1205553666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15894 CAMBRIDGE DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381011",
            "telephone_number": "586-441-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38600 VAN DYKE AVE STE 101",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121171",
            "telephone_number": "248-460-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "JILLIAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801114758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.