Individual provider Active NPI

Maxine A Thome, SOCIAL WORKER

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1245352087
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801012634 Issued in MI
Practice address
1531 Osborn Road
Lansing, MI 48915
Phone
(517) 881-5074
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 6801012634 MI Primary

Addresses

Primary practice location

1531 Osborn Road
Lansing, MI 48915

Mailing address

1531 Osborn Road
Lansing, MI 48915
Phone (517) 881-5074

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
I20150518001512 MI Practitioner - Clinical Social Worker 2062732928 Practice locations: Lansing, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1531 Osborn Rd
Lansing, MI 48915-1282
Phone (517) 484-0946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801012634MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1245352087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 OSBORN ROAD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48915",
            "telephone_number": "517-881-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 OSBORN ROAD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48915",
            "telephone_number": "517-881-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOME",
        "first_name": "MAXINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801012634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.