Individual provider Active NPI

Jacqueline Marie Hein, LMSW

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1578005153
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091583 Issued in MI
Practice address
415 Cass St
Suites 2a & 2D
Traverse City, MI 49684-2589
Phone
(231) 346-5216
Fax
(231) 943-2590
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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 6801091583 MI Primary

Addresses

Primary practice location

415 Cass St
Suites 2a & 2D
Traverse City, MI 49684-2589

Mailing address

747 E 8TH St
Traverse City, MI 49686-2662

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
I20180619002050 MI Practitioner - Clinical Social Worker 9032464805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3301 Veterans Dr
Suite 106
Traverse City, MI 49684-4592
Phone (231) 492-5412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801091583MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Calm Waters Counseling & Wellness Clinical CurrentSince Sep 1, 2022 Accepting new patients

Locations

3301 Veterans Dr
Ste 106
Traverse City, MI 49684
Phone (231) 492-5412

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": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1578005153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CASS ST",
            "address_2": "SUITES 2A & 2D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842589",
            "telephone_number": "231-346-5216",
            "fax_number": "231-943-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIN",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.