Individual provider Active NPI

Ryan P Nelson, L.L.M.S.W.

  • Clinical Social Worker
  • Monroe, MI
National Provider Identifier
1316111735
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088006 Issued in MI
Practice address
14930 Laplaisance Rd
Suite 123
Monroe, MI 48161-3880
Phone
(734) 240-3850
Fax
(734) 240-3863
NPI assigned
Apr 16, 2008
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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 6801088006 MI Primary

Addresses

Primary practice location

14930 Laplaisance Rd
Suite 123
Monroe, MI 48161-3880

Mailing address

14930 Laplaisance Rd
Suite 123
Monroe, MI 48161-3880
Phone (734) 240-3850

Other practice location 1

730 N Macomb St Ste 200
Monroe, MI 48162-2904
Phone (734) 240-1760

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
I20171117001673 MI Practitioner - Clinical Social Worker 5698031045 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088006MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions of Wellness, Inc., a Nonprofit Corporation CurrentSince Jun 26, 2025 Accepting new patients
United States Catholic Conference Past Accepting new patients
United States Catholic Conference Past Accepting new patients

Locations

17461 Allen Rd
Melvindale, MI 48122
Phone (313) 364-9042

2250 N Monroe St
Monroe, MI 48162
Phone (313) 920-8771

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1316111735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14930 LAPLAISANCE RD",
            "address_2": "SUITE 123",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481613880",
            "telephone_number": "734-240-3850",
            "fax_number": "734-240-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14930 LAPLAISANCE RD",
            "address_2": "SUITE 123",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481613880",
            "telephone_number": "734-240-3850",
            "fax_number": "734-240-3863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 N Macomb St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "MI",
            "postal_code": "481622904",
            "country_code": "US",
            "telephone_number": "734-240-1760",
            "fax_number": "734-240-1763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RYAN",
        "middle_name": "P",
        "credential": "L.L.M.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.