Individual provider Active NPI

Khadijah Murrell, LLMSW

  • Clinical Social Worker
  • Saginaw, MI
National Provider Identifier
1275064545
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851117912 Issued in MI
Practice address
3253 Congress Ave
Saginaw, MI 48602-3106
Phone
(989) 475-4171
Fax
(989) 393-6021
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X 6851117912 MI Primary

Addresses

Primary practice location

3253 Congress Ave
Saginaw, MI 48602-3106

Mailing address

2100 Hemmeter Rd
Saginaw, MI 48603-3944
Phone (989) 799-2100

Other practice location 1

2100 Hemmeter Rd
Saginaw, MI 48603-3944
Phone (989) 799-2100

Other practice location 2

41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone (248) 299-0030

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

LicenseStateTypeSpecialty
6851117912MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Direction Network Current Accepting new patients

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1275064545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HEMMETER RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033944",
            "telephone_number": "989-799-2100",
            "fax_number": "989-799-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3253 CONGRESS AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023106",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Hemmeter Rd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486033944",
            "country_code": "US",
            "telephone_number": "989-799-2100",
            "fax_number": "989-799-2637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41521 W 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751803",
            "country_code": "US",
            "telephone_number": "248-299-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURRELL",
        "first_name": "KHADIJAH",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851117912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.