Individual provider Active NPI

Jean Nemenzik, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1578640637
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
440 Burroughs St
Detroit, MI 48202-3429
Phone
(313) 348-5790
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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 Primary

Addresses

Primary practice location

440 Burroughs St
Detroit, MI 48202-3429

Mailing address

440 Burroughs St
Detroit, MI 48202-3429
Phone (313) 348-5790

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
I20061215000416 MI Practitioner - Clinical Social Worker 3779582929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mind and Body Wellness LLC Clinical CurrentSince Jan 18, 2026 Accepting new patients
Alternative Community Living, Inc. PastSince Sep 24, 2023 Accepting new patients
Fairsky Foundation Clinical PastSince May 16, 2016 Accepting new patients

Locations

440 Burroughs St
Detroit, MI 48202
Phone (313) 348-5790

440 Burroughs St
Ste 328
Detroit, MI 48202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1578640637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 BURROUGHS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023429",
            "telephone_number": "313-348-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BURROUGHS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023429",
            "telephone_number": "313-348-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMENZIK",
        "first_name": "JEAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.