NPIMap

Organization Active NPI

Catholic Social Services of Washtenaw County

  • Voluntary or Charitable Agency
  • Ann Arbor, MI
National Provider Identifier
1679687339
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
CATHOLIC SOCIAL SERVICES OF WASHTENAW COUNTY
Practice address
4925 Packard St
Ann Arbor, MI 48108-1521
Phone
(734) 971-9781
Fax
(734) 971-2730
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Mrs. Peggy McDonagh Bravo, RN, BSN, MA
Title
President and Ceo
Phone
(734) 926-0154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

4925 Packard St
Ann Arbor, MI 48108-1521

Mailing address

4925 Packard St
Ann Arbor, MI 48108-1521
Phone (734) 971-9781

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051110000039 MI Part B Supplier - Clinic/Group Practice 0547288300 Receives reassigned benefits from 7 practitioners
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

4925 Packard St
Ann Arbor, MI 48108
Phone (734) 971-9781

Practitioners & affiliated clinicians

Practitioners 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1679687339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781",
            "fax_number": "734-971-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781",
            "fax_number": "734-971-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC SOCIAL SERVICES OF WASHTENAW COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "MCDONAGH",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "734-926-0154",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, BSN, MA"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.