Individual provider Active NPI

Cory Mullins, LMSW QIDP

  • Clinical Social Worker
  • Highland, MI
National Provider Identifier
1346546934
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092551 Issued in MI
Practice address
1185 Gleneagles
Highland, MI 48357-4781
Phone
(248) 895-1455
NPI assigned
Jan 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 6801092551 MI Primary

Addresses

Primary practice location

1185 Gleneagles
Highland, MI 48357-4781

Mailing address

1185 Gleneagles
Highland, MI 48357-4781
Phone (248) 895-1455

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
I20150416002510 MI Practitioner - Clinical Social Worker 4880912179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092551MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Macomb CurrentSince Sep 13, 2025 Accepting new patients
County of Macomb CurrentSince Sep 13, 2025 Accepting new patients

Locations

19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

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": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1346546934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 GLENEAGLES",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574781",
            "telephone_number": "248-895-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 GLENEAGLES",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574781",
            "telephone_number": "248-895-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "CORY",
        "name_prefix": "Mr.",
        "credential": "LMSW QIDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-31",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, MI

Sources for this page

Verify at the official NPI Registry.