John Eagle Jr., LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801116117 Issued in MI

Practice address

3283 122ND Ave.
Allegan, MI 49010

Phone

(269) 673-5854

NPI assigned

Apr 29, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Allegan County Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Allegan, MI
  • NPI 1801119466
  NPD (past)

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1306223359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3283 122ND AVE",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "269-673-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3283 122ND AVE.",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "49010",
            "telephone_number": "269-673-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLE",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802082302",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron James Dortch, LMSW
• Mary Susan Dotson
• Susan E Doyle, MSW
• Dr. Luciano Giovannucci P.C.
• Mirna Dusek
• Bradley Michael Eddy
• Marissa L Engelhardt, RDN
• Eric Richard Erickson, DDS
• Brandy Lynn Erlandson, BS, QMHP
• Evan a. Be, D.D.S., P.L.C.

• Clinical Social Worker in Allegan, MI
• Providers in Allegan, 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 29, 2023; 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.