Individual provider Active NPI

Alisha Rae McCabe, L.M.S.W.

  • Clinical Social Worker
  • Fenton, MI
National Provider Identifier
1356658579
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098084 Issued in MI
Practice address
17100 Silver Pkwy Ste D
Fenton, MI 48430-3468
Phone
(810) 208-0378
Fax
(810) 963-1917
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Social Worker 104100000X 6801096916 MI
Clinical Social Worker 1041C0700X 6801096916 MI
Clinical Social Worker 1041C0700X 6801098084 MI Primary

Addresses

Primary practice location

17100 Silver Pkwy Ste D
Fenton, MI 48430-3468

Mailing address

6322 E Horseshoe TRL
Linden, MI 48451-8939
Phone (810) 922-1808

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XMedicaidMI

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
I20240815002512 MI Practitioner - Clinical Social Worker 1052859592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Behavioral Health, LLCGroup PAC ID 0143768689, 6 clinicians

Practice addresses (Care Compare)

14229 Torrey Rd
Suite 3
Fenton, MI 48430-3308
Phone (810) 208-0378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801096916MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health LLC Clinical CurrentSince Jun 10, 2024 Accepting new patients

Locations

14229 Torrey Rd
#3
Fenton, MI 48430
Phone (810) 208-0378

17100 Silver Pkwy
Ste D
Fenton, MI 48430
Phone (810) 208-0378

Organizations & group practices 1

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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1356658579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 E HORSESHOE TRL",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518939",
            "telephone_number": "810-922-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 SILVER PKWY STE D",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303468",
            "telephone_number": "810-208-0378",
            "fax_number": "810-963-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "ALISHA",
        "middle_name": "RAE",
        "credential": "L.M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801096916",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096916",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.