Melissa Dawn Kruse, LMSW/ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801078299 Issued in MI

Practice address

3847 Pine Grove Ave
Suite a
Fort Gratiot, MI 48059-4265

Phone

(810) 966-3533

Fax

(810) 985-7350

NPI assigned

Aug 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Marine City, MI
  • NPI 1821133265
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356455083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3847 PINE GROVE AVE",
            "address_2": "SUITE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594265",
            "telephone_number": "810-966-3533",
            "fax_number": "810-985-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3847 PINE GROVE AVE",
            "address_2": "SUITE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594265",
            "telephone_number": "810-966-3533",
            "fax_number": "810-985-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LMSW/ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801078299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip A Kohanov, O.D.
• Richard R Kovar, DO
• Michael Brian Kreiner
• Randy Krieg, RPH
• Kristen Nicole Kronner
• Philomena Kurzawe-Breault, MA, LLP, BCBA
• Sherry Lynn Kurzym, NP-BC
• Lindsay Marie Labelle, O.D.
• Matthew Lagrange
• Lake Huron Urgent Care Center, LLC

• Clinical Social Worker in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.