Individual provider Active NPI

Pearle Bernick, LMSW

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1356630982
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801088426 Issued in MI
Practice address
440 Colin Cir
Ann Arbor, MI 48103-6609
Phone
(734) 337-0890
NPI assigned
Apr 5, 2011
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801088426 MI Primary

Addresses

Primary practice location

440 Colin Cir
Ann Arbor, MI 48103-6609

Mailing address

440 Colin Cir
Ann Arbor, MI 48103-6609
Phone (734) 337-0890

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
I20151221001563 MI Practitioner - Clinical Social Worker 5991006777 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088426MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of Southeastern Michigan 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1356630982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 COLIN CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036609",
            "telephone_number": "734-337-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 COLIN CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036609",
            "telephone_number": "734-337-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNICK",
        "first_name": "PEARLE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801088426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.