Individual provider Active NPI

Michael Joseph Kubiak, MA, MSW

  • Clinical Social Worker
  • Fraser, MI
National Provider Identifier
1720257074
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088344 Issued in MI
Practice address
16664 15 Mile Rd
Fraser, MI 48026-3713
Phone
(586) 294-3030
NPI assigned
Feb 20, 2008
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1-00980 MI
Clinical Social Worker 1041C0700X 6801088344 MI Primary

Addresses

Primary practice location

16664 15 Mile Rd
Fraser, MI 48026-3713

Mailing address

7845 Middlebelt Rd
Suite 201
Romulus, MI 48174-2174
Phone (734) 721-0900

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
I20141217002824 MI Practitioner - Clinical Social Worker 8123341468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

16664 15 Mile Rd
Fraser, MI 48026-3713
Phone (586) 294-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1-00980MIMDAddiction (Substance Use Disorder) Counselor
6801088344MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Counseling Services PLLC CurrentSince Nov 1, 2020 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Apr 8, 2024 Accepting new patients
Oakland Psychological Clinic, P.C. Addiction (Substance Use Disorder) Current Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 8, 2024 Accepting new patients
Motivational Empowerment Counseling Center & Associates Past Accepting new patients

Locations

2550 S Telegraph Rd
Ste 250
Bloomfld Hls, MI 48302
Phone (248) 322-0001

16664 15 Mile Rd
Fraser, MI 48026
Phone (586) 294-3030

711 W 13 Mile Rd
Ste 100
Madison Heights, MI 48071
Phone (248) 298-1000

Organizations & group practices 5

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": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1720257074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7845 MIDDLEBELT RD",
            "address_2": "SUITE 201",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481742174",
            "telephone_number": "734-721-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16664 15 MILE RD",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263713",
            "telephone_number": "586-294-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MA, MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "1-00980",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fraser, MI

Sources for this page

Verify at the official NPI Registry.