Individual provider Active NPI

Marie Hazel Putnam

  • Clinical Social Worker
  • Flint, MI
National Provider Identifier
1215187000
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
303 W Water St
Flint, MI 48503-5627
Phone
(810) 253-3888
Fax
(810) 496-8539
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801085566 MI
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

303 W Water St
Flint, MI 48503-5627

Mailing address

70 Lafayette St
Pontiac, MI 48342-2033
Phone (248) 338-7458

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
I20140827000420 MI Practitioner - Clinical Social Worker 5193943595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Therapy Center for Wellness and Recovery LLPGroup PAC ID 1456606334, 3 clinicians

Practice addresses (Care Compare)

2503 S Linden Rd
Suite 210
Flint, MI 48532-5416
Phone (810) 228-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Center for Wellness and Recovery LLP Clinical CurrentSince Jun 19, 2018 Accepting new patients
Jawad a Shah MD PC CurrentSince Feb 12, 2018 Accepting new patients
Jawad a Shah, MD PC CurrentSince Feb 12, 2018 Accepting new patients
Alternative Community Living, Inc. PastSince Sep 24, 2023 Accepting new patients

Locations

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

2503 S Linden Rd
Ste 210
Flint, MI 48532
Phone (810) 220-4300

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

Organizations & group practices 4

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1215187000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 LAFAYETTE ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422033",
            "telephone_number": "248-338-7458",
            "fax_number": "248-338-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W WATER ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035627",
            "telephone_number": "810-253-3888",
            "fax_number": "810-496-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "MARIE",
        "middle_name": "HAZEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801085566",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.