Individual provider Active NPI

Autumn Grace Heddy-Reed, LMSW, MED, ATR-BC

  • Clinical Social Worker
  • Lapeer, MI
National Provider Identifier
1831748474
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114682 Issued in MI
Practice address
1570 Suncrest Dr
Lapeer, MI 48446-1154
Phone
(810) 667-0500
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 18-095 MI
Clinical Social Worker 1041C0700X 6801114682 MI Primary

Addresses

Primary practice location

1570 Suncrest Dr
Lapeer, MI 48446-1154

Mailing address

1570 Suncrest Dr
Lapeer, MI 48446-1154
Phone (810) 667-0500

Other practice location 1

450 N Old Woodward Ave Ste 100
Birmingham, MI 48009-5361
Phone (248) 792-8273

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
I20231004001953 MI Practitioner - Clinical Social Worker 2769837152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LapeerGroup PAC ID 4183533193, 23 clinicians

Practice addresses (Care Compare)

1570 Suncrest Dr
Lapeer, MI 48446-1154
Phone (810) 667-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
6801114682MIMDClinical Social Worker
18-095MIMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lapeer CurrentSince Sep 19, 2023 Accepting new patients
County of Lapeer CurrentSince Sep 19, 2023 Accepting new patients
Robert E. Weiss Advocacy Center for Children and Youth PastSince Sep 1, 2019 Accepting new patients

Locations

1570 Suncrest Dr
Lapeer, MI 48446
Phone (810) 667-0244

Organizations & group practices 3

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": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1831748474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 SUNCREST DR",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461154",
            "telephone_number": "810-667-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 SUNCREST DR",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461154",
            "telephone_number": "810-667-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 N Old Woodward Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "MI",
            "postal_code": "480095361",
            "country_code": "US",
            "telephone_number": "248-792-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDDY-REED",
        "first_name": "AUTUMN",
        "middle_name": "GRACE",
        "credential": "LMSW, MED, ATR-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "MI",
            "license": "18-095",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.