Organization Active NPI

Jann la Dere MSW LLC

  • Clinical Social Worker
  • Indian River, MI
National Provider Identifier
1649851379
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JANN LA DERE MSW LLC
Practice address
6301 M 68 Hwy
Indian River, MI 49749-9366
Phone
(231) 203-3231
Fax
(231) 238-5003
NPI assigned
Apr 15, 2021
Last updated
Jan 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Janet Marie Ladere, LMSWNPI 1689026379
Title
Owner/Therapist
Phone
(231) 203-3231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6301 M 68 Hwy
Indian River, MI 49749-9366

Mailing address

108 S Huron St
Cheboygan, MI 49721-1627
Phone (231) 203-3231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240418002372 MI Part B Supplier - Clinic/Group Practice 5294174629 Receives reassigned benefits from 1 practitioner
Practice locations: Petoskey, MI

National Provider Directory

National Provider Directory

Locations

616 Petoskey St
Ste 3
Petoskey, MI 49770
Phone (231) 203-3231

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1649851379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S HURON ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497211627",
            "telephone_number": "231-203-3231",
            "fax_number": "231-238-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 M 68 HWY",
            "city": "INDIAN RIVER",
            "state": "MI",
            "postal_code": "497499366",
            "telephone_number": "231-203-3231",
            "fax_number": "231-238-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANN LA DERE MSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "LADERE",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "231-203-3231",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian River, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.