Individual provider Active NPI

Genevieve Dezyree Marceau, LMSW

  • Clinical Social Worker
  • Owosso, MI
National Provider Identifier
1588029235
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801102861 Issued in MI
Practice address
1596 E M 21 Ste 247
Owosso, MI 48867-9050
Phone
(989) 270-6262
Fax
(989) 419-5940
NPI assigned
Dec 23, 2015
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801115637 MI
Clinical Social Worker 1041C0700X 6801102861 MI Primary

Addresses

Primary practice location

1596 E M 21 Ste 247
Owosso, MI 48867-9050

Mailing address

1596 E M 21 Ste 247
Owosso, MI 48867-9050
Phone (989) 270-6262

Other names 1

  • Genevieve Dezyree Hanes Former name

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
I20241108001062 MI Practitioner - Clinical Social Worker 6800320177 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102861MIMDClinical Social Worker
6801115637MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Nov 6, 2024 Accepting new patients
Choices Therapeutic Solutions PLC Clinical Current Accepting new patients
Family & Childrens Services Mid-Michigan FCSM PastSince Sep 4, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1588029235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 E M 21 STE 247",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679050",
            "telephone_number": "989-270-6262",
            "fax_number": "989-419-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1596 E M 21 STE 247",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679050",
            "telephone_number": "989-270-6262",
            "fax_number": "989-419-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCEAU",
        "first_name": "GENEVIEVE",
        "middle_name": "DEZYREE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115637",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEVIEVE",
            "last_name": "HANES",
            "middle_name": "DEZYREE",
            "credential": "LLMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.