Individual provider Active NPI

Mallinda Lumsden, LMSW

  • Clinical Social Worker
  • Sault Sainte Marie, MI
National Provider Identifier
1225375439
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094905 Issued in MI
Practice address
2864 Ashmun St
Sault Sainte Marie, MI 49783-3740
Phone
(906) 632-5200
Fax
(906) 632-5276
NPI assigned
Jan 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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 6801094905 MI Primary

Addresses

Primary practice location

2864 Ashmun St
Sault Sainte Marie, MI 49783-3740

Mailing address

2864 Ashmun St
Sault Sainte Marie, MI 49783-3740
Phone (906) 632-5200

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
I20191108002003 MI Practitioner - Clinical Social Worker 4981036100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sault Tribe of Chippewa Indians 29 clinicians

Practice addresses (Care Compare)

2864 Ashmun St
Sault S Marie, MI 49783-3740
Phone (906) 632-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sault Tribe of Chippewa Indians Current Accepting new patients
Sault Tribe of Chippewa Indians CurrentSince Nov 1, 2019 Accepting new patients
Sault Tribe of Chippewa Indians Current Accepting new patients
Sault Tribe of Chippewa Indians Current Accepting new patients
Sault Tribe of Chippewa Indians CurrentSince Nov 1, 2019 Accepting new patients

Locations

2864 Ashmun St
Sault South Marie, MI 49783
Phone (906) 632-5200

Organizations & group practices 6

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": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1225375439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833740",
            "telephone_number": "906-632-5200",
            "fax_number": "906-632-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833740",
            "telephone_number": "906-632-5200",
            "fax_number": "906-632-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMSDEN",
        "first_name": "MALLINDA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.