Individual provider Active NPI

Alyssa Kleimola, LMSW-C

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1891528857
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801120825 Issued in MI
Practice address
437 Fern Ave
Jackson, MI 49202-3970
Phone
(517) 247-2033
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 6801120825 MI Primary

Addresses

Primary practice location

437 Fern Ave
Jackson, MI 49202-3970

Mailing address

437 Fern Ave Ste C
Jackson, MI 49202-3970

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
I20250918004245 MI Practitioner - Clinical Social Worker 7810491198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

437 Fern Ave
Suite C
Jackson, MI 49202-3970

4647 W Cedar Lake Rd
Greenbush, MI 48738-9716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton County Medical Center Psychological Services PLLC CurrentSince Sep 10, 2025 Accepting new patients
Clinton County Medical Center Psychological Services PLLC CurrentSince Sep 10, 2025 Accepting new patients

Locations

437 Fern Ave
Ste C
Jackson, MI 49202
Phone (517) 247-2033

1505 Waterford Pkwy
Saint Johns, MI 48879
Phone (989) 227-0710

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": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1891528857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 FERN AVE STE C",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 FERN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023970",
            "telephone_number": "517-247-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIMOLA",
        "first_name": "ALYSSA",
        "name_prefix": "Mrs.",
        "credential": "LMSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801120825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.