Individual provider Active NPI

Carol Seacord, LMSW,ACSW,BCD

  • Clinical Social Worker
  • Ada, MI
National Provider Identifier
1629118815
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801018566 Issued in MI
Practice address
519 Ada Dr SE
Suite 103
Ada, MI 49301-9024
Phone
(616) 676-4003
Fax
(616) 676-4403
NPI assigned
Feb 7, 2007
Last updated
Dec 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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 6801018566 MI Primary

Addresses

Primary practice location

519 Ada Dr SE
Suite 103
Ada, MI 49301-9024

Mailing address

PO Box 554
Ada, MI 49301-0554
Phone (616) 676-4003

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
I20050208000252 MI Practitioner - Clinical Social Worker 1658322664 Practice locations: Ada, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

519 Ada Dr SE
Suite 103
Ada, MI 49301-9024
Phone (616) 676-4003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801018566MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1629118815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 554",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493010554",
            "telephone_number": "616-676-4003",
            "fax_number": "616-676-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 ADA DR SE",
            "address_2": "SUITE 103",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019024",
            "telephone_number": "616-676-4003",
            "fax_number": "616-676-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEACORD",
        "first_name": "CAROL",
        "credential": "LMSW,ACSW,BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801018566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

Verify at the official NPI Registry.