Individual provider Active NPI

Lisa Marie Ruggeberg, MSW, CAADC

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1730499849
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801092235 Issued in MI
Practice address
4250 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone
(734) 764-6443
NPI assigned
Oct 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C-02722 MI
Social Worker 104100000X
Clinical Social Worker 1041C0700X 6801092235 MI
Social Worker 104100000X 6801092235 MI Primary

Addresses

Primary practice location

4250 Plymouth Rd
Ann Arbor, MI 48109-2700

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other names 1

  • Lisa Wolters Other 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
I20161220001088 MI Practitioner - Clinical Social Worker 9739460395 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

3131 S State St
226 Ann Arbor
Ann Arbor, MI 48108-1658
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-02722MIMDAddiction (Substance Use Disorder) Counselor
6801092235MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Jul 24, 2024 Accepting new patients
Regents of the Unversity of Michigan Social Worker CurrentSince May 3, 2020 Accepting new patients
Regents of the University of Michigan CurrentSince Dec 6, 2016 Accepting new patients
Regents of the University of Michigan Social Worker CurrentSince Dec 6, 2016 Accepting new patients
Regents of the University of Michigan Current Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

3621 S State St
#700
Ann Arbor, MI 48108

4250 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 764-0231

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

3131 S State St
Ste 226
Ann Arbor, MI 48108
Phone (734) 430-0881

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1730499849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092700",
            "telephone_number": "734-764-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGEBERG",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-02722",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092235",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801092235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WOLTERS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.