Jacqueline Kupper, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801088435 Issued in MI

Practice address

11270 E 13 Mile Rd
Warren, MI 48093-2599

Phone

(586) 738-9320

NPI assigned

Mar 15, 2007

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 names 1

• Jacqueline Riley-Kupper Former name

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Health Eastwood Behavioral HealthGroup PAC ID 2163324492, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkupper1135452@direct.hfhs.org

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.

• Henry Ford Health Eastwood Behavioral Health

  • Social Worker
  • Clinton Township, MI
  • NPI 1396787701
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Eastwood Behavioral Health

  • Psychologist
  • Saint Clair Shores, MI
  • NPI 1104044676

  Social Worker

  NPD (past)
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1831223767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19337 MELVIN ST",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480662626",
            "telephone_number": "586-219-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11270 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932599",
            "telephone_number": "586-738-9320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22708 Harper Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480801823",
            "country_code": "US",
            "telephone_number": "586-445-2210",
            "fax_number": "586-445-0070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPPER",
        "first_name": "JACQUELINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "RILEY-KUPPER",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Krsna Home Care LLC
• Corrine Joyce Kruse, RN, MSN
• KSN Home Help LLC
• Karina Kuhlman, MT
• Anita Kumar, M.D.
• Benoy Kuriakose
• Ashley Kurtz
• Steven Alan Kushner, DO
• Ada Beth Kusnetz, M.D.
• Danelle A Kutner, DO

• Clinical Social Worker in Warren, MI
• Providers in Warren, 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 Dec 12, 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.