Catholic Social Services of the U.P.
Organization Active NPI Clinical Social Worker · Marquette, MI
NPI 1619907052 · NPPES record last updated Jun 10, 2014
Key facts
- NPI
- 1619907052
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 520056 (MI)
- Legal business name
- CATHOLIC SOCIAL SERVICES OF THE U.P.
- Practice address
- 347 Rock St
Marquette, MI 49855-4725 - Phone
- (906) 227-9118
- Fax
- (906) 228-2469
- NPI assigned
- Jul 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Linda M. Featherstone
- Title
- Office Manager
- Phone
- (906) 227-9118
Corporate family (same tax ID) 12
Practitioners 6
-
Mary Diane Tryan, LMSW
-
Alisha Ann Young, LLMSW
-
Lisa Diane Niemisto, LMSW
-
Lynda Gail Dunbar, LCSW
-
Elizabeth Pangrazzi, PSYD LP CAADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060906000215 | MI | Part B Supplier - Clinic/Group Practice | 7012999865 |
Receives reassigned benefits from 6 practitioners Practice locations: Escanaba, MI; Marquette, MI |
National Provider Directory
- Tax ID family
- Catholic Charities of the Upper Peninsula
Locations
1401 N 26th St
Ste 116
Escanaba, MI 49829
Phone (906) 786-7212
N10199 Lake Rd
Ironwood, MI 49938
Phone (906) 932-0138
347 Rock St
Marquette, MI 49855
Phone (906) 227-9119
517 W Easterday Ave
Sault South Marie, MI 49783
Phone (906) 635-1508
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 520056 | MI | Yes |
Addresses
Primary practice location
347 Rock St
Marquette, MI 49855-4725
Mailing address
347 Rock St
Marquette, MI 49855-4725
Phone (906) 227-9118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7509106790 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 7509106440 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 7509105340 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 7509105360 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 7509106980 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 7509105520 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
Other providers in Marquette, MI
- Robert John Carroll
- Lisa M Carter
- Elizabeth Case
- Cheryl L Cass
- Catherine Greer Cole LMSW PLLC
- Catholic Social Services of the Up
- Caught Dreamin' Therapy, LLC
- Mark D Cecilio
- Cedar Tree
- Theresa Champion
All providers in Marquette, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.