Individual provider Active NPI

Jessica Anne Hausler, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1356658173
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090329 Issued in MI
Practice address
8600 Woodward Ave
Detroit, MI 48202-2142
Phone
(313) 875-7601
Fax
(313) 875-7622
NPI assigned
Sep 1, 2010
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 6801090329 MI Primary

Addresses

Primary practice location

8600 Woodward Ave
Detroit, MI 48202-2142

Mailing address

8600 Woodward Ave
Detroit, MI 48202-2142
Phone (313) 875-7601

Other practice location 1

6549 Town Center Dr Ste A
Clarkston, MI 48346-4824
Phone (248) 620-6400

Other names 1

  • Jessica Anne Holmes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1356658173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022142",
            "telephone_number": "313-875-7601",
            "fax_number": "313-875-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022142",
            "telephone_number": "313-875-7601",
            "fax_number": "313-875-7622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6549 Town Center Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483464824",
            "country_code": "US",
            "telephone_number": "248-620-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUSLER",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HOLMES",
            "middle_name": "ANNE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.