Individual provider Active NPI

Kelly Lynn Sawyer, LLMSW

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1609398361
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801101135 Issued in MI
Practice address
1777 Axtell Dr Ste 101
Troy, MI 48084-4400
Phone
(248) 613-5377
NPI assigned
Jul 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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 6801101135 MI Primary

Addresses

Primary practice location

1777 Axtell Dr Ste 101
Troy, MI 48084-4400

Mailing address

54 Rose Brier Dr
Rochester Hills, MI 48309-1120
Phone (248) 568-3787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801101135MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Intention LLC Clinical CurrentSince Feb 16, 2020 Accepting new patients

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": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1609398361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 ROSE BRIER DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091120",
            "telephone_number": "248-568-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 AXTELL DR STE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844400",
            "telephone_number": "248-613-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYER",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801101135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.