Individual provider Active NPI

Kari Fedewa, LMSW

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1528870417
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095170 Issued in MI
Practice address
12232 Hillside Dr
Plymouth, MI 48170-3054
Phone
(734) 945-5302
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 6801095170 MI Primary

Addresses

Primary practice location

12232 Hillside Dr
Plymouth, MI 48170-3054

Mailing address

12232 Hillside Dr
Plymouth, MI 48170-3054
Phone (734) 945-5302

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
I20250711003386 MI Practitioner - Clinical Social Worker 2365957065 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians
Stance Health PAGroup PAC ID 4880181155, 2 clinicians

Practice addresses (Care Compare)

Detroit, MI 48243
Phone (323) 205-7088

336 W 1St St
Suite 113
Flint, MI 48502-1382
Phone (313) 604-8765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095170MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kari Fedewa, LMSW, LLC Clinical CurrentSince May 4, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Stance Health PA Clinical CurrentSince Sep 1, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jun 11, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

407 Lincoln Rd
Ste 6H
Miami Beach, FL 33139
Phone (305) 563-4258

400 Renaissance Ctr
Detroit, MI 48243
Phone (248) 599-1582

336 W 1st St
Ste 113
Flint, MI 48502
Phone (248) 254-6407

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

Organizations & group practices 4

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": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1528870417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12232 HILLSIDE DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703054",
            "telephone_number": "734-945-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12232 HILLSIDE DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703054",
            "telephone_number": "734-945-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDEWA",
        "first_name": "KARI",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.