Individual provider Active NPI

Juliette Leilani Nielsen, LMSW

  • Social Worker
  • Clare, MI
National Provider Identifier
1225669542
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
429 N McEwan St
Clare, MI 48617-1402
Phone
(989) 317-8668
Fax
(989) 355-0734
NPI assigned
Jan 27, 2020
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 NU Primary

Addresses

Primary practice location

429 N McEwan St
Clare, MI 48617-1402

Mailing address

429 N McEwan St
Clare, MI 48617-1402
Phone (989) 317-8668

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
I20240925004465 MI Practitioner - Clinical Social Worker 4385185685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Willow Oak Counseling Services PLLCGroup PAC ID 8022404656, 2 clinicians

Practice addresses (Care Compare)

1205 S Mission St
14 Wocs Mount Pleasant Office
Mount Pleasant, MI 48858-3939
Phone (989) 317-8668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Oak Counseling Services PLLC Single Specialty CurrentSince Sep 18, 2024 Accepting new patients

Locations

429 N McEwan St
Clare, MI 48617
Phone (989) 317-8668

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1225669542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171402",
            "telephone_number": "989-317-8668",
            "fax_number": "989-355-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171402",
            "telephone_number": "989-317-8668",
            "fax_number": "989-355-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "JULIETTE",
        "middle_name": "LEILANI",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

Verify at the official NPI Registry.