Mary Theel, LMSW
Individual provider Active NPI Clinical Social Worker · Capac, MI
NPI 1689008161 · NPPES record last updated Mar 31, 2026
Key facts
- NPI
- 1689008161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801097995 (MI)
- Practice address
- 14675 Downey Rd
Capac, MI 48014 - Phone
- (810) 395-4343
- NPI assigned
- Sep 3, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Clair County Community Mental Health Authority
Practice addresses (Care Compare)
14675 Downey Rd
Mussey, MI 48014-3121
Phone (810) 395-4343
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180329001563 | MI | Practitioner - Clinical Social Worker | 0446512594 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801097995 | MI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801097995 | MI | Yes |
Addresses
Primary practice location
14675 Downey Rd
Capac, MI 48014
Mailing address
3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900
Other providers in Capac, MI
- Amy Lynn Simpson
- St Clair County Community Mental Health Authority
- St Clair County Community Mental Health Sud Services - Capac
- Marney Beth Studaker-Cordner
- Maria Guadalupe Sustaita
- Holly Topor
- Stacy M Wynn
All providers in Capac, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.