Individual provider Active NPI

Canaan McLain, BSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1427610260
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801118204 Issued in MI
Practice address
610 S Burdick St
Kalamazoo, MI 49007-5221
Phone
(269) 381-3700
Fax
(269) 381-3810
NPI assigned
Jul 2, 2019
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801118204 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

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: 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
I20250118000122 MI Practitioner - Clinical Social Worker 0345779492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801118204MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo County Community Mental Health Authority CurrentSince Dec 14, 2024 Accepting new patients
Kalamazoo County Community Mental Health Authority CurrentSince Dec 14, 2024 Accepting new patients

Locations

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

418 W Kalamazoo Ave
Kalamazoo, MI 49007
Phone (269) 373-6000

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

615 E Crosstown Pkwy
Kalamazoo, MI 49001
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1427610260",
    "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": "MCLAIN",
        "first_name": "CANAAN",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118204",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.