NPIMap

Organization Active NPI

Maturity Matters

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1386353472
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MATURITY MATTERS
Practice address
220 Collingwood St Ste 140
Ann Arbor, MI 48103-3842
Phone
(734) 657-2351
NPI assigned
Nov 17, 2022
Last updated
Nov 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leslie Dubin, MSWNPI 1043816820
Title
Clinical Social Worker
Phone
(734) 657-2351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

220 Collingwood St Ste 140
Ann Arbor, MI 48103-3842

Mailing address

2302 Highland Dr
Ann Arbor, MI 48105-1088
Phone (734) 657-2351

Other identifiers 1

IdentifierTypeStateIssuer
15070172OtherMICAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL leslied@heckendorntherapy.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230503000311 MI Part B Supplier - Clinic/Group Practice 5597120204 Receives reassigned benefits from 18 practitioners
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

1880 W Stadium Blvd
Ann Arbor, MI 48103
Phone (734) 369-6163

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1386353472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 HIGHLAND DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051088",
            "telephone_number": "734-657-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 COLLINGWOOD ST STE 140",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033842",
            "telephone_number": "734-657-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATURITY MATTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "DUBIN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "734-657-2351",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15070172",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "leslied@heckendorntherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "220 Collingwood St Ste 140",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481033842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.