Madison Ottjepka, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801119521 Issued in MI

Practice address

6221 King Rd
Marine City, MI 48039-1428

Phone

(810) 765-8539

NPI assigned

Oct 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Madison Queener Former name

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Clair County Community Mental Health AuthorityGroup PAC ID 7416861984, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Port Huron, MI
  • NPI 1689783672
  Medicare reassignment Care Compare group NPD
• St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Marine City, MI
  • NPI 1821133265
  NPD

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1770126955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BROADWAY ST",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480391607",
            "telephone_number": "810-765-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 KING RD",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480391428",
            "telephone_number": "810-765-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTJEPKA",
        "first_name": "MADISON",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "QUEENER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Renee Morris
• Karen Anita Murphy
• Stuart Neale
• Norbert C. Zimmer P.C.
• Teresa Olack, DDS, MS
• Patricia Marie Parise, OTR
• Peter R Pashley, D.O
• Dipa Patel, D.D.S
• Pegasus Therapy LLC
• Lucio Lorenzo Persichetti, D.D.S

• Clinical Social Worker in Marine City, MI
• Providers in Marine City, 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 Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.