Individual provider Active NPI

Rebecca Nowak, LMSW

  • Social Worker
  • Clinton Township, MI
National Provider Identifier
1568879120
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
39425 Garfield Rd Ste 23
Clinton Township, MI 48038-4651
Phone
(800) 693-1916
Fax
(248) 605-3525
NPI assigned
Jul 16, 2014
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary
Clinical Social Worker 1041C0700X 6801095128 MI

Addresses

Primary practice location

39425 Garfield Rd Ste 23
Clinton Township, MI 48038-4651

Mailing address

23136 Norcrest Dr
Saint Clair Shores, MI 48080-2551
Phone (586) 322-7307

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
I20160314000997 MI Practitioner - Clinical Social Worker 0143526467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

39425 Garfield Rd
Suite 23
Clinton TWP, MI 48038-4651
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095128MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Mar 15, 2022 Accepting new patients

Locations

22600 Hall Rd
Ste 201
Clinton Twp, MI 48036
Phone (586) 469-5275

39425 Garfield Rd
Ste 23
Clinton Twp, MI 48038
Phone (248) 266-5616

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Organizations & group practices 2

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": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1568879120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23136 NORCREST DR",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802551",
            "telephone_number": "586-322-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39425 GARFIELD RD STE 23",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480384651",
            "telephone_number": "800-693-1916",
            "fax_number": "248-605-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.