Jennifer Miyamoto, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801114379 Issued in MI

Practice address

524 E Milham Ave Ste B
Portage, MI 49002-1473

Phone

(269) 264-4920

NPI assigned

Sep 6, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MI

  Medicare reassignment NPD
• Sondermind, P.a.

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1710647581

  Mental Health, MI

  Medicare reassignment NPD
• Michigan Emdr Therapy, PLLC

  • Adult Mental Health Clinic/Center
  • Waterford, MI
  • NPI 1487508982
  NPD Authorized official
• Michigan Emdr Therapy, PLLC

  • Clinical Social Worker
  • Waterford, MI
  • NPI 1629923396
  NPD Authorized official
• Michigan Emdr Therapy, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterford, MI
  • NPI 1639023666
  NPD Authorized official
• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1932656030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 E MILHAM AVE STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021473",
            "telephone_number": "269-264-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 E MILHAM AVE STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021473",
            "telephone_number": "269-264-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYAMOTO",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Minert, D.C.
• Magdalena J. Misiuk, D.D.S.
• Laura H Mitchell, O.D.
• Nicholas Mitchell
• Arushi Mitha
• Niaz Mohammad, MD
• Craig Albert Mohney, M.D.
• Rachel Mol
• Mom Brain
• Alison Louise Moon

• Clinical Social Worker in Portage, MI
• Providers in Portage, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.