Individual provider Active NPI

Timothy Scott Erich

  • Clinical Social Worker
  • Berrien Springs, MI
National Provider Identifier
1629709845
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
300 W Ferry St
Berrien Springs, MI 49103-1109
Phone
(269) 815-5331
NPI assigned
Jun 20, 2022
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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 Primary

Addresses

Primary practice location

300 W Ferry St
Berrien Springs, MI 49103-1109

Mailing address

300 W Ferry St
Berrien Springs, MI 49103-1109

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
I20250731002673 MI Practitioner - Clinical Social Worker 9133637226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 W Ferry St
Berrien Springs, MI 49103-1109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Coach Psychology PLC CurrentSince Jul 1, 2025 Accepting new patients
Life Coach Psychology PLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

300 W Ferry St
Berrien Springs, MI 49103
Phone (269) 815-5331

2775 W Dickman Rd
Ste P1
Springfield, MI 49037
Phone (269) 883-6560

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": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1629709845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W FERRY ST",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W FERRY ST",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031109",
            "telephone_number": "269-815-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICH",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berrien Springs, MI

Sources for this page

Verify at the official NPI Registry.