NPIMap

Individual provider Active NPI

Avelyn Marshall, LMSW

  • Clinical Social Worker
  • Okemos, MI
National Provider Identifier
1396861928
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801016708 Issued in MI
Practice address
3493 Woods Edge Dr
Suite 103
Okemos, MI 48864-6030
Phone
(517) 886-3707
Fax
(517) 349-1973
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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 6801016708 MI Primary

Addresses

Primary practice location

3493 Woods Edge Dr
Suite 103
Okemos, MI 48864-6030

Mailing address

3493 Woods Edge Dr
Suite 103
Okemos, MI 48864-6030
Phone (517) 886-3707

Other identifiers 5

IdentifierTypeStateIssuer
138194OtherMIBLUE CARE NETWORK
1001650OtherMIMCLAREN
138194OtherMIVALUE OPTIONS
214678195OtherMIPHP-UBH
8008973350OtherMIMESSA - BLUE CROSS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801016708MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Shiawassee and Genesee Counties Past Accepting new patients
Leslie G Macauley MD PC Clinical Past Accepting new patients
Memorial Hospital Past Accepting new patients
Mareck Family and Geriatric Services, P.C. Clinical PastSince Sep 15, 2013 Accepting new patients

Organizations & group practices 4

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1396861928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3493 WOODS EDGE DR",
            "address_2": "SUITE 103",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646030",
            "telephone_number": "517-886-3707",
            "fax_number": "517-349-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 WOODS EDGE DR",
            "address_2": "SUITE 103",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646030",
            "telephone_number": "517-886-3707",
            "fax_number": "517-349-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "AVELYN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801016708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "138194",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN",
            "identifier": "1001650",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "138194",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP-UBH",
            "identifier": "214678195",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MESSA - BLUE CROSS",
            "identifier": "8008973350",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.