Individual provider Active NPI

Jeffrey Claude Loucks, LMSW

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1528550720
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801102727 Issued in MI
Practice address
2800 W Willow St
Lansing, MI 48917-1833
Phone
(517) 323-4734
Fax
(517) 886-1158
NPI assigned
Jun 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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 6801102727 MI Primary

Addresses

Primary practice location

2800 W Willow St
Lansing, MI 48917-1833

Mailing address

2800 W Willow St
Lansing, MI 48917-1833
Phone (517) 323-4734

Other practice location 1

4121 Okemos Rd Ste 15
Okemos, MI 48864-3220
Phone (517) 256-3179

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
I20220512002600 MI Practitioner - Clinical Social Worker 7416334420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4121 Okemos Rd
Suite 15
Okemos, MI 48864-3220
Phone (517) 256-3179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102727MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Illuminated Mind, PLLC Clinical CurrentSince Apr 11, 2022 Accepting new patients

Locations

4121 Okemos Rd
Ste 15
Okemos, MI 48864
Phone (517) 256-3179

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1528550720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W WILLOW ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489171833",
            "telephone_number": "517-323-4734",
            "fax_number": "517-886-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W WILLOW ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489171833",
            "telephone_number": "517-323-4734",
            "fax_number": "517-886-1158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4121 Okemos Rd Ste 15",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488643220",
            "country_code": "US",
            "telephone_number": "517-256-3179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUCKS",
        "first_name": "JEFFREY",
        "middle_name": "CLAUDE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.