Individual provider Active NPI

Daniel Kenneth Taylor, LMSW

  • Clinical Social Worker
  • Petoskey, MI
National Provider Identifier
1619014735
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801072561 Issued in MI
Practice address
One Macdonald Drive Suite B
Petoskey, MI 49770
Phone
(213) 347-6701
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801072561 MI Primary

Addresses

Primary practice location

One Macdonald Drive Suite B
Petoskey, MI 49770

Mailing address

08580 Sunset Meadow
Charlevoix, MI 49720
Phone (231) 547-9181

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
I20070425000221 MI Practitioner - Clinical Social Worker 6800991555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Country Community Mental HealthGroup PAC ID 8820052095, 18 clinicians

Practice addresses (Care Compare)

1420 Plaza Dr
Petoskey, MI 49770-9420
Phone (231) 347-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801072561MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Community Mental Health CurrentSince Feb 1, 2007 Accepting new patients
North Country Community Mental Health Past Accepting new patients
Arbor Circle Corporation Clinical PastSince Feb 14, 2011 Accepting new patients

Locations

1420 Plaza Dr
Petoskey, MI 49770
Phone (231) 347-6701

1 Macdonald Dr
Ste B
Petoskey, MI 49770
Phone 2313476701 ext. 3033

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619014735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "08580 SUNSET MEADOW",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "49720",
            "telephone_number": "231-547-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MACDONALD DRIVE SUITE B",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "213-347-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DANIEL",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801072561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.