Individual provider Active NPI

Susan Elaine McCrimmon, LMSW

  • Clinical Social Worker
  • Muskegon, MI
National Provider Identifier
1891994844
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801046558 Issued in MI
Practice address
376 E Apple Ave
Muskegon, MI 49442-3466
Phone
(231) 724-1111
Fax
(231) 724-1300
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 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 6801046558 MI Primary

Addresses

Primary practice location

376 E Apple Ave
Muskegon, MI 49442-3466

Mailing address

1579 Nottingham CT
Muskegon, MI 49445-2055
Phone (231) 744-8537

Other identifiers 1

IdentifierTypeStateIssuer
SM046558OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801046558MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1891994844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 NOTTINGHAM CT",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494452055",
            "telephone_number": "231-744-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 E APPLE AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494423466",
            "telephone_number": "231-724-1111",
            "fax_number": "231-724-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRIMMON",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801046558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SM046558",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.