Individual provider Active NPI

Deanna Fletcher, LMSW

  • Clinical Social Worker
  • Fenton, MI
National Provider Identifier
1659813319
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096903 Issued in MI
Practice address
1122 N Leroy St Ste a
Fenton, MI 48430-2789
Phone
(810) 215-1414
NPI assigned
Nov 12, 2016
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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 6801096903 MI Primary

Addresses

Primary practice location

1122 N Leroy St Ste a
Fenton, MI 48430-2789

Mailing address

1122 N Leroy St Ste a
Fenton, MI 48430-2789
Phone (810) 215-1414

Other practice location 1

1309 S. Linden Rd
Suite C
Flint, MI 48532
Phone (810) 630-1152

Other names 1

  • Deanna Burbank Former name

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
I20170111002226 MI Practitioner - Clinical Social Worker 9335218379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 N Leroy St
Suite a
Fenton, MI 48430-2789
Phone (810) 215-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801096903MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deanna Fletcher LMSW LLC Clinical CurrentSince Oct 3, 2017 Accepting new patients
Delta Family Clinic South P.C CurrentSince Dec 28, 2016 Accepting new patients

Locations

1122 N Leroy St
Ste A
Fenton, MI 48430
Phone (810) 215-1414

1309 S Linden Rd
Ste C
Flint, MI 48532
Phone (810) 626-5191

4413 Corunna Rd
Flint, MI 48532
Phone (810) 630-1152

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": "1478908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1659813319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 N LEROY ST STE A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302789",
            "telephone_number": "810-215-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 N LEROY ST STE A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302789",
            "telephone_number": "810-215-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 S. Linden Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "48532",
            "country_code": "US",
            "telephone_number": "810-630-1152",
            "fax_number": "810-630-9107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "DEANNA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-12",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "BURBANK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.