Active NPI
Jacqueline Reine Newsome, LMSW
- Clinical Social Worker
- East Lansing, MI
National Provider Identifier
1245617455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801098297
- Practice address
- 3496 E Lake Lansing Rd Ste 100
East Lansing, MI 48823-6222 - Phone
- (989) 323-7916
- NPI assigned
- Apr 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801098297 | MI | Primary |
Addresses
Primary practice location
3496 E Lake Lansing Rd Ste 100
East Lansing, MI 48823-6222
Mailing address
PO Box 10
Mason, MI 48854-0010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801098297 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bold Beginnings Therapy Services LLC | Clinical | Current | Accepting new patients |
| Sunset Voyage LLC | Clinical | Current | Accepting new patients |
| Starr Therapy Services LLC | Past | Accepting new patients |
Locations
3496 E Lake Lansing Rd
Ste 100
East Lansing, MI 48823
Phone (517) 333-0968
3496 E Lake Lansing Rd
Ste 170
East Lansing, MI 48823
Organizations & group practices 3
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.
-
- Marriage & Family Therapist
- Okemos, MI
- NPI 1891272159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613433600000",
"number": "1245617455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "MASON",
"state": "MI",
"postal_code": "488540010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3496 E LAKE LANSING RD STE 100",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488236222",
"telephone_number": "989-323-7916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWSOME",
"first_name": "JACQUELINE",
"middle_name": "REINE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-27",
"last_updated": "2021-02-16",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801098297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.