Individual provider Active NPI

Vanessa Ann Werle, MSW

  • Social Worker
  • Holland, MI
National Provider Identifier
1952493033
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801087794 Issued in MI
Practice address
12265 James St
Holland, MI 49424-8613
Phone
(616) 393-4480
Fax
(616) 393-5657
NPI assigned
Sep 28, 2006
Last updated
Jan 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801087794 MI Primary

Addresses

Primary practice location

12265 James St
Holland, MI 49424-8613

Mailing address

12265 James St
Holland, MI 49424-8613
Phone (616) 393-4480

Other identifiers 1

IdentifierTypeStateIssuer
1715928MedicaidMI

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
I20110817000926 MI Practitioner - Clinical Social Worker 9830368380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Michigan Community Mental Health AuthorityGroup PAC ID 2264498005, 14 clinicians

Practice addresses (Care Compare)

156 N 4TH St
Rogers City, MI 49779-1619
Phone (989) 734-7223

400 Johnson St
Alpena, MI 49707-1434
Phone (989) 356-2161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Michigan Community Mental Health Authority CurrentSince May 28, 2024 Accepting new patients

Locations

400 Johnson St
Alpena, MI 49707
Phone (989) 354-2515

156 N 4th St
Rogers City, MI 49779
Phone (989) 734-7223

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1952493033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12265 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248613",
            "telephone_number": "616-393-4480",
            "fax_number": "616-393-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12265 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248613",
            "telephone_number": "616-393-4480",
            "fax_number": "616-393-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERLE",
        "first_name": "VANESSA",
        "middle_name": "ANN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801087794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1715928",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.