Individual provider Active NPI

Lynn Marshall, LMSW

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1255710059
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
19401 Northline Rd
Southgate, MI 48195-2277
Phone
(734) 785-7700
Fax
(734) 287-2074
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

19401 Northline Rd
Southgate, MI 48195-2277

Mailing address

19401 Northline Rd
Southgate, MI 48195-2277
Phone (734) 785-7700

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
I20191122001530 MI Practitioner - Clinical Social Worker 8820420250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

20500 Eureka Rd
Suite 200
Taylor, MI 48180-6394
Phone (734) 285-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Guidance Center CurrentSince Nov 4, 2019 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jan 19, 2021 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jan 19, 2021 Accepting new patients

Locations

19401 Northline Rd
Southgate, MI 48195
Phone (734) 785-7718

13101 Allen Rd
Southgate, MI 48195
Phone (734) 785-7701

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.lynnmarshall@150339.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1255710059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952277",
            "telephone_number": "734-785-7700",
            "fax_number": "734-287-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952277",
            "telephone_number": "734-785-7700",
            "fax_number": "734-287-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.