Individual provider Active NPI

Kathy Samir Chebli, LMSW

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1801943162
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085790 Issued in MI
Practice address
420 S Waverly Rd
Ste 4
Lansing, MI 48917-3632
Phone
(517) 708-8215
Fax
(517) 708-8223
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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 6801085790 MI Primary

Addresses

Primary practice location

420 S Waverly Rd
Ste 4
Lansing, MI 48917-3632

Mailing address

5022 Rifle River TRL
Alger, MI 48610-9327
Phone (989) 516-4317

Other identifiers 1

IdentifierTypeStateIssuer
1801943162MedicaidMI

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
I20040929000556 MI Practitioner - Clinical Social Worker 0345219010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 S Waverly Rd
Suite 4
Lansing, MI 48917-3632
Phone (517) 708-8215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Beginning Therapy Services, LLC Clinical CurrentSince Feb 13, 2013 Accepting new patients
Leslie G Macauley MD PC Clinical Past Accepting new patients

Locations

420 S Waverly Rd
Ste 4
Lansing, MI 48917
Phone (517) 708-8215

Organizations & group practices 2

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1801943162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 RIFLE RIVER TRL",
            "city": "ALGER",
            "state": "MI",
            "postal_code": "486109327",
            "telephone_number": "989-516-4317",
            "fax_number": "989-345-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S WAVERLY RD",
            "address_2": "STE 4",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489173632",
            "telephone_number": "517-708-8215",
            "fax_number": "517-708-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEBLI",
        "first_name": "KATHY",
        "middle_name": "SAMIR",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801943162",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.