Individual provider Active NPI

Jennifer Lynn Ganshorn, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1215366794
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
343 S Main St Ste 211
Ann Arbor, MI 48104-2138
Phone
(734) 412-7400
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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 Primary

Addresses

Primary practice location

343 S Main St Ste 211
Ann Arbor, MI 48104-2138

Mailing address

343 S Main St Ste 211
Ann Arbor, MI 48104-2138
Phone (734) 412-7400

Other practice location 1

3469 E Grand River Ave
Howell, MI 48843-8504
Phone (810) 844-1184

Other practice location 2

120 Flint Rd
Brighton, MI 48116-1112
Phone (810) 844-1184

Other names 1

  • Ms. Jennifer Lynn Galonska Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 4, 2024 through Mar 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1215366794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 S MAIN ST STE 211",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042138",
            "telephone_number": "734-412-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 S MAIN ST STE 211",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042138",
            "telephone_number": "734-412-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3469 E Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488438504",
            "country_code": "US",
            "telephone_number": "810-844-1184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Flint Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481161112",
            "country_code": "US",
            "telephone_number": "810-844-1184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANSHORN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GALONSKA",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.