Individual provider Active NPI

Karhonda Fails, LMSW

  • Clinical Social Worker
  • Grand Blanc, MI
National Provider Identifier
1710649538
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
10801 S Saginaw St Ste D
Grand Blanc, MI 48439-8126
Phone
(810) 771-4074
NPI assigned
Oct 8, 2021
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 Primary

Addresses

Primary practice location

10801 S Saginaw St Ste D
Grand Blanc, MI 48439-8126

Mailing address

5115 Eldred St
Flint, MI 48504-1237

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
I20241223002280 MI Practitioner - Clinical Social Worker 2769919299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creekside Counseling Group LLCGroup PAC ID 9133521255, 33 clinicians

Practice addresses (Care Compare)

10801 S Saginaw St
Suite D
Grand Blanc, MI 48439-8126
Phone (810) 771-4074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Counseling Group LLC Social Worker CurrentSince Nov 19, 2024 Accepting new patients

Locations

10801 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 771-4074

Organizations & group practices 1

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": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1710649538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 ELDRED ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485041237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 S SAGINAW ST STE D",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398126",
            "telephone_number": "810-771-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILS",
        "first_name": "KARHONDA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.