Individual provider Active NPI

Elizabeth Ann Bauer, LMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1376193359
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801105590 Issued in MI
Practice address
218 Fast Ice Dr
Midland, MI 48642-6167
Phone
(989) 426-9295
NPI assigned
Sep 12, 2019
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 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 6801105590 MI Primary

Addresses

Primary practice location

218 Fast Ice Dr
Midland, MI 48642-6167

Mailing address

1013 Sandtrap Dr
Lake Isabella, MI 48893-9352
Phone (989) 330-5325

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
I20220518002228 MI Practitioner - Clinical Social Worker 6901283688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Mental Health for Central MichiganGroup PAC ID 4688660533, 44 clinicians

Practice addresses (Care Compare)

218 Fast Ice Dr
Midland, MI 48642-6167
Phone (989) 631-2320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801105590MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Clinical CurrentSince Apr 17, 2022 Accepting new patients
Community Mental Health for Central Michigan Clinical CurrentSince Apr 17, 2022 Accepting new patients

Locations

655 E Cedar Ave
Gladwin, MI 48624
Phone (989) 426-9295

218 Fast Ice Dr
Midland, MI 48642
Phone (989) 631-2320

301 S Crapo St
Ste 1
Mount Pleasant, MI 48858

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1376193359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 SANDTRAP DR",
            "city": "LAKE ISABELLA",
            "state": "MI",
            "postal_code": "488939352",
            "telephone_number": "989-330-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167",
            "telephone_number": "989-426-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.