Individual provider Active NPI

Mary Katherine Murray, LMSW

  • Clinical Social Worker
  • Warren, MI
National Provider Identifier
1417312976
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801105975 Issued in MI
Practice address
12200 E 13 Mile Rd
200
Warren, MI 48093-3093
Phone
(586) 258-0206
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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 6801105975 MI Primary

Addresses

Primary practice location

12200 E 13 Mile Rd
200
Warren, MI 48093-3093

Mailing address

38350 Chartier St
Harrison Township, MI 48045-3412
Phone (586) 899-4810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200314000038 MI Practitioner - Clinical Social Worker 1456789080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Judson Center IncGroup PAC ID 5698906907, 10 clinicians

Practice addresses (Care Compare)

12200 E 13 Mile Rd
200 Judson Center Family
Warren, MI 48093-3041
Phone (586) 573-1810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Macomb CurrentSince Jul 1, 2024 Accepting new patients
County of Macomb CurrentSince Jul 1, 2024 Accepting new patients

Locations

19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

12200 E 13 Mile Rd
Ste 200
Warren, MI 48093
Phone (586) 573-1810

Organizations & group practices 3

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": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1417312976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38350 CHARTIER ST",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480453412",
            "telephone_number": "586-899-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 E 13 MILE RD",
            "address_2": "200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933093",
            "telephone_number": "586-258-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.