Individual provider Active NPI

Megan Luczak, LLMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1851960413
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110374 Issued in MI
Practice address
720 W Wackerly St Ste 11
Midland, MI 48640-2769
Phone
(989) 832-2165
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 6801110374 MI Primary

Addresses

Primary practice location

720 W Wackerly St Ste 11
Midland, MI 48640-2769

Mailing address

PO Box 2875
Midland, MI 48641-2875
Phone (989) 832-2165

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
6801110374MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Change: Psychological & Community Services, PLC CurrentSince Jun 22, 2021 Accepting new patients

Locations

720 W Wackerly St
Ste 11
Midland, MI 48640
Phone (989) 832-2165

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1851960413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2875",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486412875",
            "telephone_number": "989-832-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W WACKERLY ST STE 11",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402769",
            "telephone_number": "989-832-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCZAK",
        "first_name": "MEGAN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.