Active NPI
Thomas Bruce Haller, LMSW, ACSW
- Clinical Social Worker
- Saginaw, MI
National Provider Identifier
1649236274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801065092
- Practice address
- 3070 Kabobel Dr
Saginaw, MI 48604 - Phone
- (989) 791-4191
- Fax
- (989) 791-4191
- NPI assigned
- Apr 22, 2006
- Sex
- Male
- 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 | 6801065092 | MI | Primary |
Addresses
Primary practice location
3070 Kabobel Dr
Saginaw, MI 48604
Mailing address
3070 Kabobel Dr
Saginaw, MI 48604
Phone (989) 791-4191
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8008949790 | Other | MI | BLUE CROSS |
| 112622 | Other | MI | VALUE OPTIONS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1649236274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3070 KABOBEL DR",
"city": "SAGINAW",
"state": "MI",
"postal_code": "48604",
"telephone_number": "989-791-4191",
"fax_number": "789-791-4191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3070 KABOBEL DR",
"city": "SAGINAW",
"state": "MI",
"postal_code": "48604",
"telephone_number": "989-791-4191",
"fax_number": "989-791-4191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLER",
"first_name": "THOMAS",
"middle_name": "BRUCE",
"name_prefix": "Mr.",
"credential": "LMSW, ACSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-22",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801065092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "8008949790",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "112622",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.