Individual provider Active NPI

Paul Krueger, BSW

  • Social Worker
  • Alpena, MI
National Provider Identifier
1881017374
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802087438 Issued in MI
Practice address
400 Johnson St
Alpena, MI 49707-1434
Phone
(989) 356-2161
Fax
(989) 354-5898
NPI assigned
Feb 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802087438 MI Primary

Addresses

Primary practice location

400 Johnson St
Alpena, MI 49707-1434

Mailing address

400 Johnson St
Alpena, MI 49707-1434
Phone (989) 356-2161

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
I20211202002263 MI Practitioner - Clinical Social Worker 6800286048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Counseling LLCGroup PAC ID 7416354949, 20 clinicians

Practice addresses (Care Compare)

5020 E Beltline Ave NE
Suite 202
Grand Rapids, MI 49525-1077
Phone (616) 439-1866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802087438MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Counseling LLC CurrentSince Aug 30, 2022 Accepting new patients
Northeast Michigan Community Mental Health Authority PastSince Jul 20, 2005 Accepting new patients
Northeast Michigan Community Mental Health Authority Past Accepting new patients

Locations

5020 E Beltline Ave NE
Ste 202
Grand Rapids, MI 49525
Phone (616) 405-0637

Organizations & group practices 3

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": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1881017374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434",
            "telephone_number": "989-356-2161",
            "fax_number": "989-354-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434",
            "telephone_number": "989-356-2161",
            "fax_number": "989-354-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "PAUL",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802087438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.