Abigail Carlson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851110856 Issued in MI

Practice address

1260 Buth Dr NE
Comstock Park, MI 49321-9501

Phone

(616) 279-6414

Fax

(616) 323-3966

NPI assigned

Jul 13, 2021

Last updated

Jun 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: acarlson986419@direct.hfhs.org

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.

• Applied Behavioral Science Institution LLC

  • Behavior Analyst
  • Grand Rapids, MI
  • NPI 1699272948
  NPD (past)

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1659943298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 STEVENS ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071526",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 BUTH DR NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219501",
            "telephone_number": "616-279-6414",
            "fax_number": "616-323-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ABIGAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2024-06-11",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851110856",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brightside Living LLC
• Bruce a Stewart DDS PC
• Dana Bryan
• Christine Bucholtz
• Calm Support Company LLC
• Krista Kathleen Carpenter, D.C.
• Kwanjoon Cha, PHARM.D
• Change Psychology Center
• Carissa Elaine Chase, M.D.
• Chiropractic Wellness Center PC

• Clinical Social Worker in Comstock Park, MI
• Providers in Comstock Park, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.