Individual provider Active NPI

Sandra L Larson, MSW

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1730400383
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1064 Brooklawn CT
Troy, MI 48084-2621
Phone
(313) 820-8645
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

1064 Brooklawn CT
Troy, MI 48084-2621

Mailing address

1064 Brooklawn CT
Troy, MI 48084-2621
Phone (313) 820-8645

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
I20151111001952 MI Practitioner - Clinical Social Worker 4981916889 Reassigns benefits to 1 organization
Practice locations: Clinton Township, MI; Troy, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1064 Brooklawn CT
Troy, MI 48084-2621

888 W Big Beaver Rd
Suite 780
Troy, MI 48084-4745
Phone (313) 820-8645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1730400383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 BROOKLAWN CT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842621",
            "telephone_number": "313-820-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 BROOKLAWN CT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842621",
            "telephone_number": "313-820-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SANDRA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.