Individual provider Active NPI

Karin Lee Andrus, LBSW, CADC

  • Social Worker
  • Wakefield, MI
National Provider Identifier
1801210950
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802086692 Issued in MI
Practice address
103 W US Highway 2
Wakefield, MI 49968-9515
Phone
(906) 229-6120
Fax
(906) 229-6191
NPI assigned
Feb 10, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6802086692 MI
Addiction (Substance Use Disorder) Counselor 101YA0400X 2-01258 MI
Social Worker 104100000X 6802086692 MI Primary

Addresses

Primary practice location

103 W US Highway 2
Wakefield, MI 49968-9515

Mailing address

103 W US Highway 2
Wakefield, MI 49968-9515
Phone (906) 229-6120

Other practice location 1

E23970 Pow Wow Trail
Watersmeet, MI 49969
Phone (906) 358-0252

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
2-01258MIMDAddiction (Substance Use Disorder) Counselor
6802086692MIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1801210950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W US HIGHWAY 2",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499689515",
            "telephone_number": "906-229-6120",
            "fax_number": "906-229-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W US HIGHWAY 2",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499689515",
            "telephone_number": "906-229-6120",
            "fax_number": "906-229-6191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "E23970 Pow Wow Trail",
            "address_purpose": "LOCATION",
            "city": "Watersmeet",
            "state": "MI",
            "postal_code": "49969",
            "country_code": "US",
            "telephone_number": "906-358-0252",
            "fax_number": "906-358-0254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "KARIN",
        "middle_name": "LEE",
        "credential": "LBSW, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6802086692",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01258",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802086692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.