Individual provider Active NPI

Neeshan Mehretu-Harmenil, LMSW

  • Social Worker
  • East Lansing, MI
National Provider Identifier
1710430277
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801100155 Issued in MI
Practice address
4572 S Hagadorn Rd Ste 3C
East Lansing, MI 48823-5385
Phone
(517) 896-2766
NPI assigned
Aug 1, 2016
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MI
Social Worker 104100000X 6801100155 MI Primary

Addresses

Primary practice location

4572 S Hagadorn Rd Ste 3C
East Lansing, MI 48823-5385

Mailing address

PO Box 10
Mason, MI 48854-0010

Other names 1

  • Ms. Neeshan Mehretu 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
I20181105002040 MI Practitioner - Clinical Social Worker 5294088423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4572 S Hagadorn Rd
East Lansing, MI 48823-5385
Phone (517) 896-2766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801100155MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neeshan Mehretu LMSW LLC Social Worker CurrentSince Dec 20, 2021 Accepting new patients
Palazzolo Therapy Services LLC Social Worker PastSince May 1, 2023 Accepting new patients

Locations

4572 S Hagadorn Rd
Ste 3C
East Lansing, MI 48823
Phone (517) 896-2766

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1710430277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD STE 3C",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-896-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRETU-HARMENIL",
        "first_name": "NEESHAN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801100155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEESHAN",
            "last_name": "MEHRETU",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.