Individual provider Active NPI

Julie Ann Phillips, LMSW

  • Clinical Social Worker
  • Rochester, MI
National Provider Identifier
1902103542
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801083242 Issued in MI
Practice address
414 S Main St Ste 208B
Rochester, MI 48307-2070
Phone
(586) 256-5820
Fax
(855) 493-9978
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 6801083242 MI Primary

Addresses

Primary practice location

414 S Main St Ste 208B
Rochester, MI 48307-2070

Mailing address

414 S Main St Ste 208B
Rochester, MI 48307-2070
Phone (586) 256-5820

Other names 1

  • Julie Ann Hostetler Former name

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
I20130201000233 MI Practitioner - Clinical Social Worker 2567616345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801083242MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Psychological, P.C. CurrentSince Mar 1, 2022 Accepting new patients
Perceptions Counseling Services, P.C. PastSince Mar 27, 2006 Accepting new patients

Locations

29750 Harper Ave
St Clr Shores, MI 48082
Phone (586) 296-7770

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1902103542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 S MAIN ST STE 208B",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072070",
            "telephone_number": "586-256-5820",
            "fax_number": "855-493-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 S MAIN ST STE 208B",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072070",
            "telephone_number": "586-256-5820",
            "fax_number": "855-493-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801083242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "HOSTETLER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.