Individual provider Active NPI

Robert D Perrin, LMSW

  • Clinical Social Worker
  • Saint Clair, MI
National Provider Identifier
1548221500
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081914 Issued in MI
Practice address
1322 N River Rd
Norserv Group
St Clair, MI 48079
Phone
(810) 329-4798
Fax
(810) 329-7303
NPI assigned
Mar 30, 2006
Last updated
Jul 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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 6801081914 MI Primary

Addresses

Primary practice location

1322 N River Rd
Norserv Group
St Clair, MI 48079

Mailing address

1322 N River Rd
St Clair, MI 48079
Phone (810) 329-4798

Other identifiers 1

IdentifierTypeStateIssuer
743203MedicaidMI

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
I20031215000407 MI Practitioner - Clinical Social Worker 2567369937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1124 Gratiot Blvd
Marysville, MI 48040-1133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801081914MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Balance Mental Health & Wellness, LLC CurrentSince Jun 1, 2023 Accepting new patients
St Clair County Community Mental Health Authority PastSince Oct 1, 2003 Accepting new patients

Locations

1124 Gratiot Blvd
Marysville, MI 48040
Phone (586) 214-2218

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, 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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1548221500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 N RIVER RD",
            "city": "ST CLAIR",
            "state": "MI",
            "postal_code": "48079",
            "telephone_number": "810-329-4798",
            "fax_number": "810-329-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 N RIVER RD",
            "address_2": "NORSERV GROUP",
            "city": "ST CLAIR",
            "state": "MI",
            "postal_code": "48079",
            "telephone_number": "810-329-4798",
            "fax_number": "810-329-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIN",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "743203",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair, MI

Sources for this page

Verify at the official NPI Registry.