Individual provider Active NPI

Justine Seeley

  • Clinical Social Worker
  • Fenton, MI
National Provider Identifier
1922666999
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801117593 Issued in NU
Practice address
17100 Silver Pkwy Ste D
Fenton, MI 48430-3468
Phone
(810) 208-0378
Fax
(810) 963-1917
NPI assigned
Jun 4, 2019
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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 6801117593 NU Primary

Addresses

Primary practice location

17100 Silver Pkwy Ste D
Fenton, MI 48430-3468

Mailing address

17100 Silver Pkwy Ste D
Fenton, MI 48430-3468
Phone (810) 208-0378

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
I20260227000352 MI Practitioner - Clinical Social Worker 1850872847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Behavioral Health, LLCGroup PAC ID 0143768689, 6 clinicians

Practice addresses (Care Compare)

14229 Torrey Rd
Suite 3
Fenton, MI 48430-3308
Phone (810) 208-0378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health LLC Clinical CurrentSince Jan 20, 2026 Accepting new patients

Locations

14229 Torrey Rd
#3
Fenton, MI 48430
Phone (810) 208-0378

17100 Silver Pkwy
Ste D
Fenton, MI 48430
Phone (810) 208-0378

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1922666999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 SILVER PKWY STE D",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303468",
            "telephone_number": "810-208-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 SILVER PKWY STE D",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303468",
            "telephone_number": "810-208-0378",
            "fax_number": "810-963-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELEY",
        "first_name": "JUSTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": "6801117593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.