Active NPI
Jessica Schroeder, LMSW
- Clinical Social Worker
- Port Huron, MI
National Provider Identifier
1487928560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 3111 Electric Ave
Port Huron, MI 48060-8127 - Phone
- (810) 985-8900
- NPI assigned
- Mar 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
3111 Electric Ave
Port Huron, MI 48060-8127
Mailing address
3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900
Other names 1
- Jessica Freeland
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141210000539 | MI | Practitioner - Clinical Social Worker | 6305168972 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Clair County Community Mental Health Authority
Practice addresses (Care Compare)
3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900
6221 King Rd
Marine City, MI 48039-1428
Phone (810) 765-5010
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Clair County Community Mental Health Authority | Current | Accepting new patients | |
| St Clair County Community Mental Health Authority | Current | Accepting new patients |
Locations
135 Broadway St
Marine City, MI 48039
Phone (810) 400-4200
3111 Electric Ave
Port Huron, MI 48060
Phone (810) 985-4747
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Port Huron, MI
- NPI 1689783672
MI
-
- Community/Behavioral Health Agency
- Marine City, MI
- NPI 1821133265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1487928560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3111 ELECTRIC AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608127",
"telephone_number": "810-985-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 ELECTRIC AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608127",
"telephone_number": "810-985-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "JESSICA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-07",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "FREELAND",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.