Individual provider Active NPI

Janelle E Staviski, LMSW

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1467965566
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095673 Issued in MI
Practice address
207 1St St
Jackson, MI 49201-2102
Phone
(517) 998-4673
Fax
(517) 998-0005
NPI assigned
Nov 10, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 6801095673 MI Primary

Addresses

Primary practice location

207 1St St
Jackson, MI 49201-2102

Mailing address

9611 Cement City Hwy
Addison, MI 49220-9723
Phone (616) 881-6042

Other practice location 1

209 1st St
Jackson, MI 49201-2102
Phone (517) 998-4673

Other practice location 2

1218 Greenwood Ave
Jackson, MI 49203-3037
Phone (517) 998-4673

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
6801095673MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Days Therapy LLC CurrentSince Jul 12, 2020 Accepting new patients

Locations

11 E Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-7100

Organizations & group practices 1

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": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467965566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 CEMENT CITY HWY",
            "city": "ADDISON",
            "state": "MI",
            "postal_code": "492209723",
            "telephone_number": "616-881-6042",
            "fax_number": "517-998-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1ST ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012102",
            "telephone_number": "517-998-4673",
            "fax_number": "517-998-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 1st St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492012102",
            "country_code": "US",
            "telephone_number": "517-998-4673",
            "fax_number": "517-998-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1218 Greenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492033037",
            "country_code": "US",
            "telephone_number": "517-998-4673",
            "fax_number": "517-998-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVISKI",
        "first_name": "JANELLE",
        "middle_name": "E",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.