Active NPI
Jacey Plantenberg, MSW
- Clinical Social Worker
- Ann Arbor, MI
National Provider Identifier
1912670621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801121940
- Practice address
- 4250 Plymouth Rd
Ann Arbor, MI 48109-2700 - Phone
- (734) 764-0231
- NPI assigned
- Jul 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 6801121940 | MI | Primary |
Addresses
Primary practice location
4250 Plymouth Rd
Ann Arbor, MI 48109-2700
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
1300 N 17th Ave
Greeley, CO 80631-9584
Phone (970) 347-2120
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3621 S State St
Ann Arbor, MI 48108-1633
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1912670621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4250 PLYMOUTH RD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481092700",
"telephone_number": "734-764-0231"
}
],
"practiceLocations": [
{
"address_1": "1300 N 17th Ave",
"address_purpose": "LOCATION",
"city": "Greeley",
"state": "CO",
"postal_code": "806319584",
"country_code": "US",
"telephone_number": "970-347-2120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PLANTENBERG",
"first_name": "JACEY",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-28",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801121940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.