Individual provider Active NPI

Dawn Lee Criswell, LMSW

  • Clinical Social Worker
  • Three Rivers, MI
National Provider Identifier
1346644630
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085912 Issued in MI
Practice address
57341 Buckhorn Rd
Three Rivers, MI 49093-8105
Phone
(269) 506-0060
Fax
(888) 272-2630
NPI assigned
Oct 15, 2014
Last updated
Nov 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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 6801085912 MI Primary

Addresses

Primary practice location

57341 Buckhorn Rd
Three Rivers, MI 49093-8105

Mailing address

57341 Buckhorn Rd
Three Rivers, MI 49093-8105
Phone (269) 506-0060

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
I20141201002032 MI Practitioner - Clinical Social Worker 1557683612 Practice locations: Three Rivers, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

57341 Buckhorn Rd
Three Rivers, MI 49093-8105
Phone (269) 506-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1346644630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57341 BUCKHORN RD",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938105",
            "telephone_number": "269-506-0060",
            "fax_number": "888-272-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57341 BUCKHORN RD",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938105",
            "telephone_number": "269-506-0060",
            "fax_number": "888-272-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISWELL",
        "first_name": "DAWN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.