Individual provider Active NPI

Jeffrey Fleming, MSW

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1477106763
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801113561 Issued in MI
Practice address
3475 Belle Chase Way
Lansing, MI 48911-4252
Phone
(517) 882-3732
Fax
(517) 882-3732
NPI assigned
Jul 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 6801113561 MI Primary

Addresses

Primary practice location

3475 Belle Chase Way
Lansing, MI 48911-4252

Mailing address

1440 Sherwood Ave
East Lansing, MI 48823-1852
Phone (517) 337-1663

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
I20211104001042 MI Practitioner - Clinical Social Worker 3577951946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1422 W Saginaw St
East Lansing, MI 48823-2434
Phone (517) 331-0949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801113561MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Change Therapy LLC Social Worker CurrentSince Oct 1, 2022 Accepting new patients

Locations

1422 W Saginaw St
East Lansing, MI 48823
Phone (517) 243-6426

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1477106763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 SHERWOOD AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231852",
            "telephone_number": "517-337-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 BELLE CHASE WAY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114252",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "JEFFREY",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.