Steven Richard Fair, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801069238 Issued in MI

Practice address

100 NB Gratiot Ave
Mount Clemens, MI 48043

Phone

(586) 783-2950

Fax

(586) 690-4333

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renewal Christian Counseling Inc 20 clinicians

Practice addresses (Care Compare)

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.

• Renewal Christian Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Clemens, MI
  • NPI 1548211535

  Clinical, MI

  Medicare reassignment Care Compare group NPD
• Blue Water Center for Christian Counseling P.C.

  • Mental Health Counselor
  • Port Huron, MI
  • NPI 1558494633
  NPD (past)
• Renewal Christian Counseling Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Gratiot, MI
  • NPI 1174799209
  NPD (past)
• Renewal Christian Counseling Inc

  • Clinical Social Worker
  • Mount Clemens, MI
  • NPI 1548648322

  Clinical

  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1780690909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NB GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432301",
            "telephone_number": "586-783-2950",
            "fax_number": "586-690-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NB GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-783-2950",
            "fax_number": "586-690-4333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24401 Capital Blvd",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480361343",
            "country_code": "US",
            "telephone_number": "586-783-2950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIR",
        "first_name": "STEVEN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801069238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES HMO",
            "identifier": "139863SW",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "235213000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "9817558",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0892947",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "149663",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "SF069238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Luis C. Escudero, PT
• Ian Albert Etheart, DO
• Valerie Ettinger, RN
• Kilolo Bibi Everson, LLMSW
• Extended Handz LLC
• Dominic Carl Fano, D.O.
• Robert Guy Farrell Jr., O.D.
• Osama M Fashho
• Maha Asar Fasihi
• Salman A Fateh, D.O.

• All providers in Mount Clemens, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.