Theresa Ellen Marshall, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087866 Issued in MI

Practice address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Phone

(231) 737-1335

Fax

(231) 737-0534

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackley Community Care Center IncGroup PAC ID 8123015492, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hackley Community Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1629066238
  Medicare reassignment Care Compare group NPD
• Hackley Community Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1427787621
  NPD
• Life Guidance Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1336185032
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641081600000",
    "number": "1629117734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442203",
            "telephone_number": "231-739-4359",
            "fax_number": "231-733-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-1335",
            "fax_number": "231-737-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "THERESA",
        "middle_name": "ELLEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-01-02",
        "certification_date": "2022-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801087866",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629066238",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231858",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4483587",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theresamarshall@hccc.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Hackley Community Care Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2700 Baker St Fl 3",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494442157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carisa Joy Marotti, LLPC
• Joseph J Marous III, MD
• Christopher L Marquart, M.D.
• Charles Joseph Marshak
• Barrett Marshall, DDS
• Zachary D Marsman
• Martell & Company Home Care and Assistance
• Alicia Anne Martin, LMSW
• Amanda Martin, PHARMD
• Elizabeth M Martin

• Clinical Social Worker in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.