Individual provider Active NPI

Kelly Jane Kreger, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1356698146
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090445 Issued in MI
Practice address
1785 W Stadium Blvd
Suite 203C
Ann Arbor, MI 48103-5285
Phone
(734) 913-1093
Fax
(734) 454-3570
NPI assigned
Aug 10, 2012
Last updated
Aug 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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 6801090445 MI Primary

Addresses

Primary practice location

1785 W Stadium Blvd
Suite 203C
Ann Arbor, MI 48103-5285

Mailing address

3694 Clarkston Rd
Suite D
Clarkston, MI 48348-5213
Phone (248) 693-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1356698146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3694 CLARKSTON RD",
            "address_2": "SUITE D",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485213",
            "telephone_number": "248-693-8880",
            "fax_number": "248-391-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 W STADIUM BLVD",
            "address_2": "SUITE 203C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035285",
            "telephone_number": "734-913-1093",
            "fax_number": "734-454-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREGER",
        "first_name": "KELLY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.