Individual provider Active NPI

Lynn Therese Mejia, LMSW

  • Clinical Social Worker
  • Warren, MI
National Provider Identifier
1215955117
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087224 Issued in MI
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5872
Fax
(586) 573-5583
NPI assigned
Jul 18, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MI
Clinical Social Worker 1041C0700X 6801087224 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

39012 Lanse Creuse St
Harrison Township, MI 48045-2065
Phone (248) 835-2124

Other practice location 1

22101 Moross Rd
Detroit, MI 48236-2148
Phone (313) 343-4176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801087224MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215955117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39012 LANSE CREUSE ST",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480452065",
            "telephone_number": "248-835-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5872",
            "fax_number": "586-573-5583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22101 Moross Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362148",
            "country_code": "US",
            "telephone_number": "313-343-4176",
            "fax_number": "313-343-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "LYNN",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.