Octavia Camille Amerson, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801098831 Issued in MI

Practice address

1040 W Bristol Rd
Flint, MI 48507-5516

Phone

(810) 287-9248

NPI assigned

Dec 14, 2015

Last updated

Jun 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Octavia Camille Williams Former name

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesee Health SystemGroup PAC ID 6002051091, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesee Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1043554348
  Medicare reassignment Care Compare group NPD
• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD
• Genesee Health System

  dba Genesee Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Flint, MI
  • NPI 1962140137

  Clinical

  NPD
• Alternative Community Living, Inc.

  dba Hope Network - New Passages

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saginaw, MI
  • NPI 1487008652
  NPD (past)

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1437524634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485075516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485075516",
            "telephone_number": "810-287-9248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8245 Holly Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484392483",
            "country_code": "US",
            "telephone_number": "810-242-3740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMERSON",
        "first_name": "OCTAVIA",
        "middle_name": "CAMILLE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801098831",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OCTAVIA",
            "last_name": "WILLIAMS",
            "middle_name": "CAMILLE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Amend
• American Healthcore LLC
• American Medical Equipments Inc
• Amerihomecare Inc
• Maraijah Amerson
• Faiza Amin, MD
• Muhammad Amin, PT
• Mohamadali H Amlani, M.D.
• Darcie Amsdill, SLP
• Saarah Amuthan, D.D.S.

• Social Worker in Flint, MI
• Providers in Flint, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.