Individual provider Active NPI

Mary O'Connor

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1629479761
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801104108 Issued in MI
Practice address
14800 Arcola St
Livonia, MI 48154-3966
Phone
(313) 408-8678
NPI assigned
Sep 9, 2014
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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 NU
Clinical Social Worker 1041C0700X 6801104108 MI Primary

Addresses

Primary practice location

14800 Arcola St
Livonia, MI 48154-3966

Mailing address

14800 Arcola St
Livonia, MI 48154-3966
Phone (313) 408-8678

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address moconnor391497@direct.hfhs.org

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
I20220429000918 MI Practitioner - Clinical Social Worker 1254728850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

6773 W Maple Rd
West Bloomfield, MI 48033-3013
Phone (248) 661-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801104108MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Clinical CurrentSince Apr 28, 2022 Accepting new patients
Henry Ford Health System CurrentSince Apr 28, 2022 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6773 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 661-6100

Interoperability endpoints

  • Direct secure messaging: moconnor574415@direct.hfhs.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1629479761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 ARCOLA ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543966",
            "telephone_number": "313-408-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 ARCOLA ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543966",
            "telephone_number": "313-408-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moconnor391497@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "14800 Arcola St",
            "city": "Livonia",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481543966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.