Gary Kirk Rasmussen, LMSW, PSY.S. PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801077900 Issued in MI

Practice address

739 Hendrie Blvd
Royal Oak, MI 48067-3150

Phone

(586) 872-8643

Fax

(248) 584-3334

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Downriver Mental Health Clinic PC

  dba Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  Medicare reassignment

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1255626727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 HENDRIE BLVD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673150",
            "telephone_number": "586-872-8643",
            "fax_number": "248-584-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 HENDRIE BLVD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673150",
            "telephone_number": "586-872-8643",
            "fax_number": "248-584-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "GARY",
        "middle_name": "KIRK",
        "name_prefix": "Mr.",
        "credential": "LMSW, PSY.S. PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grasmussen14652@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandeep Randhawa, MD
• Shannon Marie Ranella, PA
• Steven M Rankin, MD
• Allyson Ranville
• Krishna Moorthy Rao, PT
• Vaneerat Ratanatharathorn, MD
• Jessica Ratkiewicz, OTRL
• Elizabeth Rau
• K P. Ravikrishnan, MD
• Sarah Lynn Rawski, PA-C

• Clinical Social Worker in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.