Individual provider Active NPI

Kerrie Summerhill

  • Clinical Social Worker
  • South Haven, MI
National Provider Identifier
1962109371
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
13560 76TH St Ste 3
South Haven, MI 49090-9483
Phone
(269) 202-6059
NPI assigned
Feb 15, 2023
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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 Primary

Addresses

Primary practice location

13560 76TH St Ste 3
South Haven, MI 49090-9483

Mailing address

13560 76TH St Ste 3
South Haven, MI 49090-9483
Phone (269) 202-6059

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
I20260507003620 MI Practitioner - Clinical Social Worker 6204304207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13560 76TH St
Suite 3
South Haven, MI 49090-9483

885 Penniman Ave
Unit 5425
Plymouth, MI 48170-7729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ruth Lee Center for Healing and Growth Clinical Past Accepting new patients
Katara Therapy, LLC Clinical Past Accepting new patients

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, 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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1962109371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13560 76TH ST STE 3",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909483",
            "telephone_number": "269-202-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13560 76TH ST STE 3",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909483",
            "telephone_number": "269-202-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERHILL",
        "first_name": "KERRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Haven, MI

Sources for this page

Verify at the official NPI Registry.