Individual provider Active NPI

Annemarie Rini, LCSW

  • Clinical Social Worker
  • La Porte, IN
National Provider Identifier
1740909811
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009820A Issued in IN
Practice address
611 3Rd St
La Porte, IN 46350-4803
Phone
(219) 242-0424
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 34009820A IN Primary

Addresses

Primary practice location

611 3Rd St
La Porte, IN 46350-4803

Mailing address

611 3Rd St
La Porte, IN 46350-4803

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
I20240223001712 MI Practitioner - Clinical Social Worker 4082090881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kathryn Miller PHD PCGroup PAC ID 0042289274, 13 clinicians

Practice addresses (Care Compare)

19855 Outer Dr
Suite 300W
Dearborn, MI 48124-2189
Phone (313) 359-1977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kathryn Miller PHD PC Clinical CurrentSince Jan 13, 2024 Accepting new patients

Locations

19855 Outer Dr
Ste 300W
Dearborn, MI 48124
Phone (313) 359-1977

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1740909811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 3RD ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463504803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 3RD ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463504803",
            "telephone_number": "219-242-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINI",
        "first_name": "ANNEMARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009820A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

Verify at the official NPI Registry.