Individual provider Active NPI

Mark Duane Pruitt, LCSW

  • Clinical Social Worker
  • Ypsilanti, MI
National Provider Identifier
1538273743
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801115195 Issued in MI
Practice address
904 Hawthorne Ave
Ypsilanti, MI 48198-5812
Phone
(734) 431-2166
NPI assigned
Aug 18, 2006
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1187 KY
Clinical Social Worker 1041C0700X 6801115195 MI Primary
Clinical Social Worker 1041C0700X 34003875A IN

Addresses

Primary practice location

904 Hawthorne Ave
Ypsilanti, MI 48198-5812

Mailing address

875 Hawthorne Ave Ste 1
Ypsilanti, MI 48198-5825
Phone (734) 431-2166

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
I20230726000924 MI Practitioner - Clinical Social Worker 3779944558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

904 Hawthorne Ave
Ypsilanti, MI 48198-5812
Phone (734) 431-2166

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
90
Improvement activities
40
Cost
82.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1187KYMDPsychologist
34003875AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Mel Bornstein Clinic for Psychoanalysis and Psychotherapy CurrentSince Jul 3, 2023 Accepting new patients
Balanced Being Psychotherapy PLLC Clinical CurrentSince Jun 1, 2024 Accepting new patients
Supportive Care I of Michigan PC Clinical CurrentSince Oct 1, 2023 Accepting new patients
Counseling Associates of Southern Indiana, PSC Clinical Past Accepting new patients
Seven Counties Services, Inc. Social Worker Past Accepting new patients
St Joseph Mercy Hospital PastSince Jun 1, 2024 Accepting new patients

Locations

2006 Hogback Rd
Ann Arbor, MI 48105
Phone (734) 786-2300

32841 Middlebelt Rd
Ste 403
Farmington Hills, MI 48334
Phone (248) 851-7739

330 Lincoln Ave
Iron River, MI 49935
Phone (810) 445-5300

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1538273743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 HAWTHORNE AVE STE 1",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985825",
            "telephone_number": "734-431-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 HAWTHORNE AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985812",
            "telephone_number": "734-431-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "MARK",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "1187",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115195",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003875A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.