Individual provider Active NPI

Sharon Longbucco, LMSW

  • Clinical Social Worker
  • Grand Blanc, MI
National Provider Identifier
1639686272
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087420 Issued in MI
Practice address
5445 Ali Dr Dept 320
Grand Blanc, MI 48439-5193
Phone
(810) 428-1181
Fax
(810) 426-0009
NPI assigned
Jan 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 6801087420 MI Primary

Addresses

Primary practice location

5445 Ali Dr Dept 320
Grand Blanc, MI 48439-5193

Mailing address

5445 Ali Dr Dept 320
Grand Blanc, MI 48439-5193
Phone (810) 428-1181

Other identifiers 1

IdentifierTypeStateIssuer
6801087420OtherMILICENSE

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
I20200331000455 MI Practitioner - Clinical Social Worker 8527497353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cognosis Health HillsideGroup PAC ID 5890158901, 15 clinicians

Practice addresses (Care Compare)

10761 S Saginaw St
Suite D
Grand Blanc, MI 48439-8168
Phone (810) 428-1181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801087420MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cognosis Health Hillside CurrentSince Aug 26, 2023 Accepting new patients
Genesys Practice Partners, Inc. Past Accepting new patients
Cognosis Health PastSince Nov 12, 2023 Accepting new patients

Locations

5445 Ali Dr
#320
Grand Blanc, MI 48439
Phone (810) 428-1181

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1639686272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 ALI DR DEPT 320",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395193",
            "telephone_number": "810-428-1181",
            "fax_number": "810-426-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 ALI DR DEPT 320",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395193",
            "telephone_number": "810-428-1181",
            "fax_number": "810-426-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGBUCCO",
        "first_name": "SHARON",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6801087420",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.