Individual provider Active NPI

Maryleigh King, LMSW

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1790249472
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098069 Issued in MI
Practice address
340 N Main St Ste 200
Plymouth, MI 48170-1250
Phone
(734) 335-0028
NPI assigned
Jan 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 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 6801098069 MI Primary

Addresses

Primary practice location

340 N Main St Ste 200
Plymouth, MI 48170-1250

Mailing address

1510 E Lincoln Ave
Royal Oak, MI 48067-3402
Phone (248) 561-9863

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230130001674 MI Practitioner - Clinical Social Worker 5395116339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Simply Mindful Counseling LLCGroup PAC ID 6800282963, 12 clinicians

Practice addresses (Care Compare)

340 N Main St
Suite 201
Plymouth, MI 48170-1290
Phone (734) 335-0605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801098069MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Mindful Counseling, LLC Clinical CurrentSince Jan 15, 2023 Accepting new patients

Locations

36700 Woodward Ave
Ste 109
Bloomfield Hills, MI 48304
Phone (248) 702-4020

340 N Main St
Ste 200
Plymouth, MI 48170
Phone (734) 335-0028

340 N Main St
Ste 201
Plymouth, MI 48170
Phone (734) 335-0605

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1790249472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 E LINCOLN AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673402",
            "telephone_number": "248-561-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MAIN ST STE 200",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701250",
            "telephone_number": "734-335-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MARYLEIGH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.