Individual provider Active NPI

Mason Bushnell, LLMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1316653298
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2010 Hogback Rd Ste 6G
Ann Arbor, MI 48105-8800
Phone
(734) 386-0041
NPI assigned
Jan 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 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 Primary

Addresses

Primary practice location

2010 Hogback Rd Ste 6G
Ann Arbor, MI 48105-8800

Mailing address

3708 Pratt Rd
Ann Arbor, MI 48103-1433
Phone (201) 675-1937

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

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Neuropsychology Services, Inc Clinical CurrentSince Jan 29, 2023 Accepting new patients

Locations

2010 Hogback Rd
Ste 6G
Ann Arbor, MI 48105
Phone (734) 386-0041

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": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1316653298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 PRATT RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031433",
            "telephone_number": "201-675-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 HOGBACK RD STE 6G",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481058800",
            "telephone_number": "734-386-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "MASON",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.