Individual provider Active NPI

Aesha Mustafa, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1912442302
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095233 Issued in MI
Practice address
122 S Main St
Suite 200
Ann Arbor, MI 48104-1929
Phone
(734) 945-6210
NPI assigned
Dec 21, 2016
Last updated
Dec 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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 6801095233 MI Primary

Addresses

Primary practice location

122 S Main St
Suite 200
Ann Arbor, MI 48104-1929

Mailing address

3200 Greenfield Rd
Suite 250
Dearborn, MI 48120-1802

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

40433 Koppernick Rd
Canton, MI 48187-4283

PO Box
Suite 131487
Ann Arbor, MI 48113-1487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095233MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Empowerment Group, PLLC CurrentSince Jun 27, 2026 Accepting new patients

Locations

124 Pearl St
Ste 207
Ypsilanti, MI 48197
Phone (734) 481-0180

Organizations & group practices 1

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": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1912442302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GREENFIELD RD",
            "address_2": "SUITE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST",
            "address_2": "SUITE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041929",
            "telephone_number": "734-945-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "AESHA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.