Individual provider Active NPI

Stacey Marie Mejia, LMSW, CAADC

  • Clinical Social Worker
  • Novi, MI
National Provider Identifier
1932465325
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801066758 Issued in MI
Practice address
43450 W 10 Mile Rd
Novi, MI 48375-3172
Phone
(248) 344-7420
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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 6801066758 MI Primary

Addresses

Primary practice location

43450 W 10 Mile Rd
Novi, MI 48375-3172

Mailing address

43450 W 10 Mile Rd
Novi, MI 48375-3172
Phone (248) 344-7420

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
I20130315000428 MI Practitioner - Clinical Social Worker 8022253210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northbrook Psychological Clinic PLCGroup PAC ID 3577456243, 4 clinicians

Practice addresses (Care Compare)

23965 Novi Rd
Suite 110
Novi, MI 48375-3232
Phone (248) 344-7420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801066758MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northbrook Psychological Clinic PLC CurrentSince Oct 11, 2016 Accepting new patients
Bobbi Ebsen Psychotherapy LLC Clinical PastSince Oct 11, 2016 Accepting new patients

Locations

43450 W 10 Mile Rd
Novi, MI 48375
Phone (248) 344-7420

23965 Novi Rd
Ste 110
Novi, MI 48375
Phone (248) 344-3172

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1932465325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43450 W 10 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753172",
            "telephone_number": "248-344-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43450 W 10 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753172",
            "telephone_number": "248-344-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.