Individual provider Active NPI

Karrissa Kay Labelle, LMSW-C

  • Clinical Social Worker
  • Grand Blanc, MI
National Provider Identifier
1770284085
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801103950 Issued in MI
Practice address
12332 Moceri Dr
Grand Blanc, MI 48439-1928
Phone
(810) 210-5540
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 6801103950 MI Primary

Addresses

Primary practice location

12332 Moceri Dr
Grand Blanc, MI 48439-1928

Mailing address

12332 Moceri Dr
Grand Blanc, MI 48439-1928
Phone (810) 210-5540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801103950MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1770284085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12332 MOCERI DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391928",
            "telephone_number": "810-210-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12332 MOCERI DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391928",
            "telephone_number": "810-210-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABELLE",
        "first_name": "KARRISSA",
        "middle_name": "KAY",
        "credential": "LMSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.