Individual provider Active NPI

Marsha Ann Macniell, LMSW,CSW

  • Clinical Social Worker
  • Mt Pleasant, MI
National Provider Identifier
1902869019
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4101005776 Issued in MI
Practice address
4676 E Broomfield Rd Ste E
Mt Pleasant, MI 48858-9192
Phone
(989) 954-9962
Fax
(989) 893-0461
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 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 4101005776 MI Primary

Addresses

Primary practice location

4676 E Broomfield Rd Ste E
Mt Pleasant, MI 48858-9192

Mailing address

1405 Crosslanes St
Mt Pleasant, MI 48858-1941
Phone (989) 327-4744

Other identifiers 1

IdentifierTypeStateIssuer
P16440008OtherMIMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.mamacniell.com

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
I20060105000374 MI Practitioner - Clinical Social Worker 0042233082 Practice locations: Mt Pleasant, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1405 Crosslanes St
Mount Pleasant, MI 48858-1941

4676 E Broomfield Rd
Suite E
Mt Pleasant, MI 48858-9192
Phone (989) 954-9962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4101005776MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hema Talasila MD PLLC Clinical CurrentSince Apr 5, 2012 Accepting new patients
Venkat Talasila PastSince Apr 5, 2012 Accepting new patients
Catholic Family Service Past Accepting new patients

Locations

200 S Wenona St
Ste G29
Bay City, MI 48706
Phone (989) 893-3212

2578 McLeod Dr N
Ste 1
Saginaw, MI 48604
Phone (989) 799-5440

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1902869019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CROSSLANES ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488581941",
            "telephone_number": "989-327-4744",
            "fax_number": "989-893-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4676 E BROOMFIELD RD STE E",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488589192",
            "telephone_number": "989-954-9962",
            "fax_number": "989-893-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACNIELL",
        "first_name": "MARSHA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMSW,CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "4101005776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "P16440008",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mamacniell.com",
            "affiliation": "N",
            "address_1": "4676 E Broomfield Rd Ste E",
            "city": "MT Pleasant",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488589192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.