Individual provider Active NPI

Shanice Easley

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1619325792
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098210 Issued in MI
Practice address
19750 Burt Rd
Detroit, MI 48219-2078
Phone
(313) 977-9550
NPI assigned
May 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801098210 MI
Clinical Social Worker 1041C0700X 6801098210 MI Primary

Addresses

Primary practice location

19750 Burt Rd
Detroit, MI 48219-2078

Mailing address

19750 Burt Rd
Detroit, MI 48219-2078
Phone (313) 977-9550

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
I20220608000657 MI Practitioner - Clinical Social Worker 8325426059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Easterseals Morc Health Care, IncGroup PAC ID 9830141670, 129 clinicians

Practice addresses (Care Compare)

6900 E 10 Mile Rd
Easter Seals Macomb County
Center Line, MI 48015-1168
Phone (586) 501-3070

Merit-based Incentive Payment System (MIPS)

Final score
93.79 of 100Reported as group
Quality
90.17
Promoting interoperability
83
Improvement activities
40
Cost
86.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801098210MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Macomb CurrentSince May 29, 2023 Accepting new patients
County of Macomb CurrentSince May 29, 2023 Accepting new patients
Easterseals Morc Health Care, Inc. CurrentSince Feb 3, 2023 Accepting new patients
Hegira Health, Inc. Past Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

6900 E 10 Mile Rd
Center Line, MI 48015
Phone (586) 501-3070

19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

Organizations & group practices 4

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": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1619325792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19750 BURT RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192078",
            "telephone_number": "313-977-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19750 BURT RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192078",
            "telephone_number": "313-977-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASLEY",
        "first_name": "SHANICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-30",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801098210",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.