Individual provider Active NPI

Rachel Alexandra Kwiatkoski, LLMSW

  • Clinical Social Worker
  • Mount Clemens, MI
National Provider Identifier
1679820450
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094128 Issued in MI
Practice address
175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562
Phone
(248) 302-9178
NPI assigned
Aug 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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 6801094128 MI Primary

Addresses

Primary practice location

175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562

Mailing address

175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562
Phone (248) 302-9178

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
I20160921002294 MI Practitioner - Clinical Social Worker 0244527018 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Macomb CurrentSince Aug 19, 2024 Accepting new patients
Joel L. Young, M.D., P.C. Clinical CurrentSince Dec 17, 2024 Accepting new patients
County of Macomb CurrentSince Aug 19, 2024 Accepting new patients

Locations

19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

21885 Dunham Rd
Ste 2
Clinton Twp, MI 48036
Phone (586) 469-5950

175 N Groesbeck Hwy
Mount Clemens, MI 48043
Phone (586) 713-5103

441 S Livernois Rd
Ste 100
Rochester Hills, MI 48307
Phone (248) 608-8800

Organizations & group practices 3

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": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1679820450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "248-302-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "248-302-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIATKOSKI",
        "first_name": "RACHEL",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.