Individual provider Active NPI

Jannaice McPeake, MSW

  • Clinical Social Worker
  • Waterford, MI
National Provider Identifier
1861520587
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5525 Walling Dr
Waterford, MI 48329-3264
Phone
(313) 529-0422
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Primary

Addresses

Primary practice location

5525 Walling Dr
Waterford, MI 48329-3264

Mailing address

5525 Walling Dr
Waterford, MI 48329-3264
Phone (313) 529-0422

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
I20050917000077 MI Practitioner - Clinical Social Worker 5193758365 Reassigns benefits to 1 organization
Practice locations: Waterford, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Independent Behavioral Health GroupGroup PAC ID 1759658966, 6 clinicians

Practice addresses (Care Compare)

4413 Corunna Rd
Flint, MI 48532-4321
Phone (810) 733-5735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Behavioral Health Group CurrentSince Mar 2, 2019 Accepting new patients
Life Coach Problem Solvers Clinical Past Accepting new patients

Locations

4413 Corunna Rd
Flint, MI 48532
Phone (810) 630-1152

Organizations & group practices 2

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861520587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 WALLING DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293264",
            "telephone_number": "313-529-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 WALLING DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293264",
            "telephone_number": "313-529-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPEAKE",
        "first_name": "JANNAICE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.