Organization Active NPI

Flourish Center for Cultivating Human Potential

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1669920344
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097448 Issued in MI
Legal business name
FLOURISH CENTER FOR CULTIVATING HUMAN POTENTIAL
Practice address
2301 E Michigan Ave Ste 214
Jackson, MI 49202-3765
Phone
(517) 745-8682
Fax
(517) 513-6536
NPI assigned
Sep 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Authorized official

Name
Mrs. Korah Hoffman, LMSW, MPANPI 1396148581
Title
Founder/Ceo
Phone
(517) 745-8682

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 WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801097448 MI Primary

Addresses

Primary practice location

2301 E Michigan Ave Ste 214
Jackson, MI 49202-3765

Mailing address

2301 E Michigan Ave Ste 214
Jackson, MI 49202-3765
Phone (517) 745-8682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170306001182 MI Part B Supplier - Clinic/Group Practice 2860776150 Receives reassigned benefits from 4 practitioners
Practice locations: Spring Arbor, MI

National Provider Directory

National Provider Directory

Locations

915 Airport Rd
Ste 8
Jackson, MI 49202
Phone (517) 745-8682

2301 E Michigan Ave
Ste 214
Jackson, MI 49202
Phone (517) 745-3512

328 E Main St
Spring Arbor, MI 49283
Phone (517) 745-8682

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1669920344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E MICHIGAN AVE STE 214",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023765",
            "telephone_number": "517-745-8682",
            "fax_number": "517-513-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E MICHIGAN AVE STE 214",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023765",
            "telephone_number": "517-745-8682",
            "fax_number": "517-513-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOURISH CENTER FOR CULTIVATING HUMAN POTENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "KORAH",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "517-745-8682",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW, MPA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.