Individual provider Active NPI

Amy Rouleau, LLBSW

  • Clinical Social Worker
  • Mason, MI
National Provider Identifier
1366871899
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6802087870 Issued in MI
Practice address
585 Jewett Rd
Mason, MI 48854-8729
Phone
(517) 676-5405
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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 6802087870 MI Primary

Addresses

Primary practice location

585 Jewett Rd
Mason, MI 48854-8729

Mailing address

2 Brookfield
Swartz Creek, MI 48473-1295
Phone (517) 676-5405

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6802087870MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1366871899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROOKFIELD",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731295",
            "telephone_number": "517-676-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 JEWETT RD",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488548729",
            "telephone_number": "517-676-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROULEAU",
        "first_name": "AMY",
        "credential": "LLBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802087870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.