Jessica Deverman, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801109341 Issued in MI

Practice address

114 N Mitchell St
Cadillac, MI 49601-1833

Phone

(231) 846-4783

Fax

(231) 468-2572

NPI assigned

Apr 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Supportive Services of Northern Michigan LLCGroup PAC ID 5092051144, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Supportive Services of Northern Michigan LLC

  • Clinical Social Worker
  • Cadillac, MI
  • NPI 1164943353
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1659952836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N MITCHELL ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011833",
            "telephone_number": "231-846-4783",
            "fax_number": "231-468-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N MITCHELL ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011833",
            "telephone_number": "231-846-4783",
            "fax_number": "231-468-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERMAN",
        "first_name": "JESSICA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801109341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "231-468-2572",
            "address_1": "114 N Mitchell St",
            "city": "Cadillac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496011833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dental Health Professionals
• Alexandrea Joann Depew, BCBA, LBA
• Craig Allen Derror, PHD
• Keagan Derror, LLMSW
• Jennifer Deruiter
• Jordyn Dhondt
• Marianne Tison Dickerson, CNM
• James Matthew Diener, D.O.
• Kimberley Diener
• Kelly Sue Diffin Ball, COTA/L

• Clinical Social Worker in Cadillac, MI
• Providers in Cadillac, 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 Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.