Individual provider Active NPI

Deborah Dianne Kupres, LMSW

  • Clinical Social Worker
  • Allegan, MI
National Provider Identifier
1861008955
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801117438 Issued in MI
Practice address
540 Jenner Dr
Allegan, MI 49010-1517
Phone
(269) 673-6617
NPI assigned
Sep 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801107297 MI
Clinical Social Worker 1041C0700X 6801117438 MI Primary

Addresses

Primary practice location

540 Jenner Dr
Allegan, MI 49010-1517

Mailing address

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 673-6617

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
I20240208001593 MI Practitioner - Clinical Social Worker 2264875020 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
Allegan County Community Mental Health ServicesGroup PAC ID 1153317607, 25 clinicians

Practice addresses (Care Compare)

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 673-6617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801107297MIMDClinical Social Worker
6801117438MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allegan County Community Mental Health Services CurrentSince Dec 30, 2023 Accepting new patients
Allegan County Community Mental Health Services CurrentSince Dec 30, 2023 Accepting new patients
Bethany Christian Services Inc. PastSince Sep 1, 2020 Accepting new patients
Bethany Christian Services, Inc PastSince Sep 1, 2020 Accepting new patients

Locations

540 Jenner Dr
Allegan, MI 49010
Phone (269) 673-6617

3285 122nd Ave
Allegan, MI 49010
Phone (269) 673-6617

Organizations & group practices 4

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": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1861008955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-673-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-673-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPRES",
        "first_name": "DEBORAH",
        "middle_name": "DIANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801107297",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

Verify at the official NPI Registry.