Active NPI
Kelsey Fanslau, LMSW
- Social Worker
- Whitmore Lake, MI
National Provider Identifier
1447880554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801111370
- Practice address
- 9260 Walnut Dr
Whitmore Lake, MI 48189-9280 - Phone
- (616) 648-0782
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801104944 | MI | |
| Social Worker | 104100000X | 6801111370 | MI | Primary |
Addresses
Primary practice location
9260 Walnut Dr
Whitmore Lake, MI 48189-9280
Mailing address
9260 Walnut Dr
Whitmore Lake, MI 48189-9280
Phone (616) 648-0782
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801111370 | MI | MD | Social Worker |
| 6801104944 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1447880554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9260 WALNUT DR",
"city": "WHITMORE LAKE",
"state": "MI",
"postal_code": "481899280",
"telephone_number": "616-648-0782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9260 WALNUT DR",
"city": "WHITMORE LAKE",
"state": "MI",
"postal_code": "481899280",
"telephone_number": "616-648-0782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANSLAU",
"first_name": "KELSEY",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801104944",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "MI",
"license": "6801111370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitmore Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.