Tiffany Mazurek, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801075829 Issued in MI

Practice address

6144 Devon St
Portage, MI 49024-2648

Phone

(734) 709-2096

NPI assigned

Feb 5, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sacred Healing Therapeutic Services LLC

  • Social Worker
  • Portage, MI
  • NPI 1952806556
  Medicare reassignment NPD

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1780008284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6144 DEVON ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242648",
            "telephone_number": "734-709-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 DEVON ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242648",
            "telephone_number": "734-709-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUREK",
        "first_name": "TIFFANY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801075829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Sidney Maudlin, DDS
• Nancy L Maudlin, NP
• Barbara Mauragis
• Jessica Joyce Mayer, MA, LPC
• Caroline Mazon, MA, BCBA, LBA
• Betty Mbangwana
• Michael David McCallister
• David C McClintic, OD
• Natalie McClish, ATC
• Thomas A McClure

• Clinical Social Worker in Portage, MI
• Providers in Portage, 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 Jan 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.