Individual provider Active NPI

Patricia K Criswell, LMSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1669534129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801061844 Issued in MI
Practice address
5340 Holiday Ter
Kalamazoo, MI 49009-2196
Phone
(269) 372-4140
Fax
(269) 372-0390
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801061844 MI Primary

Addresses

Primary practice location

5340 Holiday Ter
Kalamazoo, MI 49009-2196

Mailing address

5340 Holiday Ter
Kalamazoo, MI 49009-2196
Phone (269) 372-4140

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
I20231031003842 MI Practitioner - Clinical Social Worker 0749636470 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801061844MIMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669534129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140",
            "fax_number": "269-372-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140",
            "fax_number": "269-372-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISWELL",
        "first_name": "PATRICIA",
        "middle_name": "K",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801061844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.