Individual provider Active NPI

James R. Stanislaw, MSW

  • Social Worker
  • Troy, MI
National Provider Identifier
1629254297
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801012574 Issued in MI
Practice address
625 E Big Beaver Rd
Suite 101
Troy, MI 48083-1426
Phone
(248) 740-9360
Fax
(248) 740-9374
NPI assigned
Jan 14, 2008
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801012574 MI Primary

Addresses

Primary practice location

625 E Big Beaver Rd
Suite 101
Troy, MI 48083-1426

Mailing address

625 E Big Beaver Rd
Suite 101
Troy, MI 48083-1426
Phone (248) 740-9360

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
I20080404000765 MI Practitioner - Clinical Social Worker 1951488683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Behavioral Medicine PLLCGroup PAC ID 8325069305, 24 clinicians

Practice addresses (Care Compare)

2525 Crooks Rd
Troy, MI 48084-4733
Phone (248) 731-7305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Behavioral Medicine PLLC Social Worker CurrentSince Oct 4, 2007 Accepting new patients
Michigan Behavioral Medicine Social Worker Past Accepting new patients

Locations

2525 Crooks Rd
Ste 100
Troy, MI 48084
Phone (248) 731-7305

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1629254297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E BIG BEAVER RD",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831426",
            "telephone_number": "248-740-9360",
            "fax_number": "248-740-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BIG BEAVER RD",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831426",
            "telephone_number": "248-740-9360",
            "fax_number": "248-740-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANISLAW",
        "first_name": "JAMES",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801012574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.