Individual provider Active NPI

Deborah L Reeths, ACSW

  • Clinical Social Worker
  • Ludington, MI
National Provider Identifier
1295724094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DR081198 Issued in MI
Practice address
409 W Ludington Ave
Suite 307
Ludington, MI 49431-2377
Phone
(231) 843-8877
Fax
(231) 845-0264
NPI assigned
Oct 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DR081198 MI Primary

Addresses

Primary practice location

409 W Ludington Ave
Suite 307
Ludington, MI 49431-2377

Mailing address

409 W Ludington Ave
Suite 307
Ludington, MI 49431-2377
Phone (231) 843-8877

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DR081198MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Professional Clinic, P.C. Clinical PastSince Feb 15, 2005 Accepting new patients
Lighthouse Associates LLC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295724094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W LUDINGTON AVE",
            "address_2": "SUITE 307",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312377",
            "telephone_number": "231-843-8877",
            "fax_number": "231-845-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W LUDINGTON AVE",
            "address_2": "SUITE 307",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312377",
            "telephone_number": "231-843-8877",
            "fax_number": "231-845-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REETHS",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "DR081198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.