Active NPI
Judith Lynn Church, LMSW, ACSW
- Clinical Social Worker
- Flint, MI
National Provider Identifier
1497830202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801080784
- Practice address
- 806 Tuuri PL
Flint, MI 48503-2465 - Phone
- (810) 767-5750
- NPI assigned
- Oct 27, 2006
- 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 | 6801080784 | MI | Primary |
Addresses
Primary practice location
806 Tuuri PL
Flint, MI 48503-2465
Mailing address
2465 Pebble Ridge CT
Davison, MI 48423-8621
Phone (810) 658-2432
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 |
|---|---|---|---|
| 6801080784 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lapeer Christian Counseling, LLC | Clinical | Current | Accepting new patients |
| Life Resource Center | Past | Accepting new patients | |
| Christian Family Services of Lapeer County | Past | Accepting new patients |
Locations
608 Fox St
Lapeer, MI 48446
Phone (810) 538-0229
Organizations & group practices 3
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.
-
- Mental Health Counselor
- Lapeer, MI
- NPI 1003878588
-
- Community/Behavioral Health Agency
- Lapeer, MI
- NPI 1649393646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1497830202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2465 PEBBLE RIDGE CT",
"city": "DAVISON",
"state": "MI",
"postal_code": "484238621",
"telephone_number": "810-658-2432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 TUURI PL",
"city": "FLINT",
"state": "MI",
"postal_code": "485032465",
"telephone_number": "810-767-5750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCH",
"first_name": "JUDITH",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LMSW, ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801080784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.