Individual provider Active NPI

Theresa Windham, LMSW

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1841657772
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098797 Issued in MI
Practice address
2532 Spring Arbor Rd Ste D
Jackson, MI 49203-3663
Phone
(517) 798-5555
NPI assigned
Jan 22, 2016
Last updated
May 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801098797 MI
Clinical Social Worker 1041C0700X 6801098797 MI Primary

Addresses

Primary practice location

2532 Spring Arbor Rd Ste D
Jackson, MI 49203-3663

Mailing address

1011 Whitney St
Jackson, MI 49202-2428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • 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
I20170912000445 MI Practitioner - Clinical Social Worker 8921371055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801098797MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Theresa Windham LMSW LLC Social Worker CurrentSince Jan 13, 2020 Accepting new patients

Locations

2532 Spring Arbor Rd
Ste D
Jackson, MI 49203
Phone (517) 798-5555

569 Wildwood Ave
Unit 1
Jackson, MI 49201
Phone (517) 798-5555

569 Wildwood Ave
Unit 4
Jackson, MI 49201
Phone (517) 788-6404

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1841657772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 WHITNEY ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 SPRING ARBOR RD STE D",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033663",
            "telephone_number": "517-798-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDHAM",
        "first_name": "THERESA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801098797",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.