Annette L Fortino LCSW Acsw Cac-II LLC
Organization Active NPI Social Worker · Hart, MI
NPI 1871879080 · NPPES record last updated Mar 13, 2025
Key facts
- NPI
- 1871879080
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Social Worker 104100000X
- Legal business name
- ANNETTE L FORTINO LCSW ACSW CAC-II LLC
- Practice address
- 1535 Industrial Park Dr
Hart, MI 49420-8377 - Phone
- (517) 231-6550
- NPI assigned
- Nov 1, 2011
- Organization subpart
- No
Authorized official
- Name
- Mary Beth Houpt
- Title
- Credentialing
- Phone
- (517) 676-9797
Practitioners 1
-
Annette Louise Fortino, LCSW ACSW CAC-II
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120215000793 | MI | Part B Supplier - Clinic/Group Practice | 4981862281 |
Receives reassigned benefits from 1 practitioner Practice locations: Hart, MI |
National Provider Directory
Locations
1535 Industrial Park Dr
Hart, MI 49420
Phone (517) 231-6550
6500 Centurion Dr
Ste 260
Lansing, MI 48917
Phone (517) 231-6550
101 S James St
Ste 306
Ludington, MI 49431
Phone (517) 231-6550
101 S James St
Ste 307
Ludington, MI 49431
Phone (517) 231-6550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | Yes |
Addresses
Primary practice location
1535 Industrial Park Dr
Hart, MI 49420-8377
Mailing address
PO Box 10
Mason, MI 48854-0010
Phone (517) 676-9788
Other providers in Hart, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.