Individual provider Active NPI

Megan Janisch, LLMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1376286138
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851113989 Issued in MI
Practice address
3115 Professional Dr
Ann Arbor, MI 48104-5131
Phone
(734) 975-1602
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 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 6851113989 MI Primary

Addresses

Primary practice location

3115 Professional Dr
Ann Arbor, MI 48104-5131

Mailing address

46533 Polo Dr
Canton, MI 48187-1686
Phone (734) 673-6308

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
6851113989MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Home of New Vision CurrentSince Apr 24, 2022 Accepting new patients

Locations

3115 Professional Dr
Ann Arbor, MI 48104
Phone (734) 975-1602

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": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1376286138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46533 POLO DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871686",
            "telephone_number": "734-673-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 PROFESSIONAL DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045131",
            "telephone_number": "734-975-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANISCH",
        "first_name": "MEGAN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851113989",
            "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 Apr 19, 2022; 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.