Individual provider Active NPI

Juanita Kay Meyerink, LMSW

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1356863484
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801100819 Issued in MI
Practice address
505 N Jackson St
Jackson, MI 49201-1266
Phone
(517) 748-5500
Fax
(517) 783-2728
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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 6801100819 MI Primary

Addresses

Primary practice location

505 N Jackson St
Jackson, MI 49201-1266

Mailing address

12901 E Michigan Ave
Grass Lake, MI 49240-9283

Other identifiers 1

IdentifierTypeStateIssuer
6801111105OtherMILMSW LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcaryl@cfhinc.org Health Information Exchange (HIE)

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
I20211029002282 MI Practitioner - Clinical Social Worker 1850789579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

180 W Michigan Ave
Suite 703
Jackson, MI 49201-1352
Phone (517) 240-1367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801100819MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Mindset Therapy, LLC Clinical CurrentSince Aug 19, 2022 Accepting new patients

Locations

180 W Michigan Ave
Ste 703
Jackson, MI 49201
Phone (517) 240-1367

Interoperability endpoints

  • Direct secure messaging: jmeyerink632124@direct.hfhs.org

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": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1356863484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 E MICHIGAN AVE",
            "city": "GRASS LAKE",
            "state": "MI",
            "postal_code": "492409283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500",
            "fax_number": "517-783-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERINK",
        "first_name": "JUANITA",
        "middle_name": "KAY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW LICENSE",
            "identifier": "6801111105",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcaryl@cfhinc.org",
            "affiliation": "N",
            "endpointDescription": "Organization website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "505 N Jackson St",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.