Active NPI
Susan Taylor, MSW CSW
- Clinical Social Worker
- Marshall, MI
National Provider Identifier
1336257633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801021518
- Practice address
- 15209 W Michigan Ave
Marshall, MI 49068-9570 - Phone
- (269) 781-9119
- Fax
- (269) 781-7872
- NPI assigned
- Aug 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801021518 | MI | Primary |
| Marriage & Family Therapist | 106H00000X | 4101005984 | MI |
Addresses
Primary practice location
15209 W Michigan Ave
Marshall, MI 49068-9570
Mailing address
15209 W Michigan Ave
Marshall, MI 49068-9570
Phone (269) 781-9119
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7509107630 | Other | MI | BLUE CROSS BLUE SHIELD |
| 6801021518 | Other | MI | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4101005984 | MI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakridge Counseling Center PC | Past | Accepting new patients | |
| Ella E M Brown Charitable Circle | 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.
-
- Psychologist
- Battle Creek, MI
- NPI 1598954794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1336257633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15209 W MICHIGAN AVE",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490689570",
"telephone_number": "269-781-9119",
"fax_number": "269-781-7872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15209 W MICHIGAN AVE",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490689570",
"telephone_number": "269-781-9119",
"fax_number": "269-781-7872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "SUSAN",
"credential": "MSW CSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-27",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801021518",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101005984",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7509107630",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "6801021518",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.