Individual provider Active NPI

Nancy M McDonald, LMSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1376578989
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1764302 Issued in MI
Practice address
610 S Burdick St
Kalamazoo, MI 49007-5221
Phone
(269) 381-3700
Fax
(269) 381-3810
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1764302 MI Primary

Addresses

Primary practice location

610 S Burdick St
Kalamazoo, MI 49007-5221

Mailing address

610 S Burdick St
Kalamazoo, MI 49007-5221
Phone (269) 381-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • 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
I20061024000090 MI Practitioner - Clinical Social Worker 1355348038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1764302MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo County Community Mental Health Authority CurrentSince Aug 1, 2019 Accepting new patients
Kalamazoo County Community Mental Health Authority CurrentSince Aug 1, 2019 Accepting new patients

Locations

2030 Portage St
Kalamazoo, MI 49001
Phone (269) 553-7132

615 E Crosstown Pkwy
Kalamazoo, MI 49001
Phone (269) 373-6000

610 S Burdick St
Kalamazoo, MI 49007
Phone (269) 373-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376578989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-381-3700",
            "fax_number": "269-381-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-381-3700",
            "fax_number": "269-381-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "NANCY",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "1764302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.