Individual provider Active NPI

Rose Charlotte Fox-Long, LLMSW

  • Clinical Social Worker
  • Okemos, MI
National Provider Identifier
1902682727
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851117001 Issued in MI
Practice address
2157 University Park Dr
Okemos, MI 48864-5956
Phone
(517) 243-9738
Fax
(517) 940-4863
NPI assigned
Sep 6, 2023
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 6851117001 MI Primary

Addresses

Primary practice location

2157 University Park Dr
Okemos, MI 48864-5956

Mailing address

2157 University Park Dr
Okemos, MI 48864-5956
Phone (517) 243-9738

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
I20260422000853 MI Practitioner - Clinical Social Worker 6406323922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

238 Hoover Blvd
Suite 30
Holland, MI 49423-3755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851117001MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Better Health Therapy Center LLC Clinical PastSince Sep 10, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1902682727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 UNIVERSITY PARK DR",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488645956",
            "telephone_number": "517-243-9738",
            "fax_number": "517-940-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 UNIVERSITY PARK DR",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488645956",
            "telephone_number": "517-243-9738",
            "fax_number": "517-940-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX-LONG",
        "first_name": "ROSE",
        "middle_name": "CHARLOTTE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851117001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.