Active NPI
Kathleen Nelson, LMSW, ACSW
- Clinical Social Worker
- Ann Arbor, MI
National Provider Identifier
1639422488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801070748
- Practice address
- 2350 Washtenaw Ave
Ste 6B
Ann Arbor, MI 48104-4532 - Phone
- (734) 320-4958
- NPI assigned
- Oct 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801070748 | MI | Primary |
Addresses
Primary practice location
2350 Washtenaw Ave
Ste 6B
Ann Arbor, MI 48104-4532
Mailing address
2350 Washtenaw Ave
Ste 6B
Ann Arbor, MI 48104-4532
Phone (734) 320-4958
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801070748 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493337600000",
"number": "1639422488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 WASHTENAW AVE",
"address_2": "STE 6B",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044532",
"telephone_number": "734-320-4958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 WASHTENAW AVE",
"address_2": "STE 6B",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044532",
"telephone_number": "734-320-4958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KATHLEEN",
"credential": "LMSW, ACSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-17",
"last_updated": "2017-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801070748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.