Individual provider Active NPI

Allyson McClellan, LMSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1265042493
Registry record updated Nov 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801117168 Issued in MI
Practice address
4341 S Westnedge Ave Ste 1106
Kalamazoo, MI 49008-3283
Phone
(269) 312-1446
Fax
(269) 225-6949
NPI assigned
Aug 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2023

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 6801117168 MI Primary

Addresses

Primary practice location

4341 S Westnedge Ave Ste 1106
Kalamazoo, MI 49008-3283

Mailing address

PO Box 2174
Kalamazoo, MI 49003-2174
Phone (269) 312-1446

Other practice location 1

1125 E Milham Ave Ste B
Portage, MI 49002-3096
Phone (269) 312-1446

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
I20231107001980 MI Practitioner - Clinical Social Worker 6800243221 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
Group practices
Serene SolutionsGroup PAC ID 0042641136, 17 clinicians

Practice addresses (Care Compare)

4341 S Westnedge Ave
Suite 1106
Kalamazoo, MI 49008-3283
Phone (269) 312-1446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801117168MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Solutions CurrentSince Nov 5, 2023 Accepting new patients

Locations

4341 S Westnedge Ave
Ste 1106
Kalamazoo, MI 49008
Phone (269) 312-1446

1125 E Milham Ave
Ste B
Portage, MI 49002
Phone (269) 312-1446

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699142400000",
    "number": "1265042493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2174",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490032174",
            "telephone_number": "269-312-1446",
            "fax_number": "269-225-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 S WESTNEDGE AVE STE 1106",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083283",
            "telephone_number": "269-312-1446",
            "fax_number": "269-225-6949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 E Milham Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490023096",
            "country_code": "US",
            "telephone_number": "269-312-1446",
            "fax_number": "269-225-6949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "ALLYSON",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.