Carl Glenn Hagstrom, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801071286 Issued in MI

Practice address

342 S Ashley St
Ann Arbor, MI 48104-1351

Phone

(734) 222-5040

Fax

(734) 929-4415

NPI assigned

Jul 31, 2017

Last updated

Jul 31, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1720502883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130223",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481130223",
            "telephone_number": "734-222-5040",
            "fax_number": "734-929-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 S ASHLEY ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041351",
            "telephone_number": "734-222-5040",
            "fax_number": "734-929-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "CARL",
        "middle_name": "GLENN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801071286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Hagen, M.S. CCC-SLP
• Whitney Hagen, PHD
• Avery Leigh Hager
• Adrianne Nicole Haggins, MD
• Lisa Haggitt, DPT
• Hague & Associates, Inc.
• Karen Hague
• David A Haidar, MD
• Mehdy Haidar, MD
• Syedreza Ali Haider, MD

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.