Individual provider Active NPI

Alicia Wesolek

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1386187391
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801100139 Issued in MI
Practice address
812 E Jolly Rd
Lansing, MI 48910-6818
Phone
(517) 346-8200
NPI assigned
Nov 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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 6801100139 MI Primary

Addresses

Primary practice location

812 E Jolly Rd
Lansing, MI 48910-6818

Mailing address

812 E Jolly Rd
Lansing, MI 48910-6818

Other names 1

  • Alicia Putmon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801100139MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1386187391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESOLEK",
        "first_name": "ALICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "PUTMON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.