Individual provider Active NPI

Rachel Berent Fogelberg, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1699974782
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801084583 Issued in MI
Practice address
2026 Winsted Blvd
Ann Arbor, MI 48103-6040
Phone
(734) 678-0436
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801084583 MI
Clinical Social Worker 1041C0700X 6801084583 MI Primary

Addresses

Primary practice location

2026 Winsted Blvd
Ann Arbor, MI 48103-6040

Mailing address

2026 Winsted Blvd
Ann Arbor, MI 48103-6040
Phone (734) 678-0436

Other practice location 1

4250 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 764-0231

Other practice location 2

2101 Commonwealth
Ann Arbor, MI 48105-2969
Phone (800) 525-5188

Other names 1

  • Rachel Berent Former name

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
I20090505000515 MI Practitioner - Clinical Social Worker 4981752789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 764-4190

4250 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 764-0231

4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 764-6831

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801084583MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Apr 13, 2012 Accepting new patients
Regents of the University of Michigan Social Worker CurrentSince Apr 13, 2012 Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

4250 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 764-0231

3621 S State St
#700
Ann Arbor, MI 48108

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

2101 Commonwealth Blvd
Ann Arbor, MI 48105
Phone (734) 763-9259

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1699974782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 WINSTED BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036040",
            "telephone_number": "734-678-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 WINSTED BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036040",
            "telephone_number": "734-678-0436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4250 Plymouth Rd",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481092700",
            "country_code": "US",
            "telephone_number": "734-764-0231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Commonwealth",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481052969",
            "country_code": "US",
            "telephone_number": "800-525-5188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGELBERG",
        "first_name": "RACHEL",
        "middle_name": "BERENT",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801084583",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801084583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "BERENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.