Mariah Conklin, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801099479 Issued in MI

Practice address

610 S Burdick St
Kalamazoo, MI 49007-5221

Phone

(269) 381-3700

Fax

(269) 381-3810

NPI assigned

Aug 5, 2016

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Conklin Counseling PLLC

  • Clinical Social Worker
  • Wayland, MI
  • NPI 1184560898
  NPD Authorized official

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1790239804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-381-3700",
            "fax_number": "269-381-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-381-3700",
            "fax_number": "269-381-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "MARIAH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790239804",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Streamline",
            "affiliation": "N",
            "address_1": "610 S Burdick St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Comstock Community Center
• Jean Concannon, LMSW
• Leah Condit, LPC
• Ashley Conklin, N.P.
• Eric Conklin
• Levi Jackson Conley, DIPL.AC
• Sarah Conn
• Connected Counseling LLC
• Connections in Hope Counseling LLC
• Susan Beth Connolly, O.D.

• Clinical Social Worker in Kalamazoo, MI
• Providers in Kalamazoo, 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 Jul 29, 2019; 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.