Active NPI
Jennifer Rose Fisher, LMSW
- Social Worker
- Centreville, MI
National Provider Identifier
1962700054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801092246
- Practice address
- 677 E. Main Street
Centreville, MI 49032 - Phone
- (269) 467-1000
- Fax
- (269) 467-3072
- NPI assigned
- Mar 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801092246 | MI | Primary |
Addresses
Primary practice location
677 E. Main Street
Centreville, MI 49032
Mailing address
677 E. Main Street
Centreville, MI 49032
Phone (269) 467-1000
Other practice location 1
451 Health Pkwy Ste B
Paw Paw, MI 49079-8242
Phone (269) 655-3065
Other names 1
- Jennifer Rose Thick
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct.direct@bronsonhg.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801092246 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1962700054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 E. MAIN STREET",
"city": "CENTREVILLE",
"state": "MI",
"postal_code": "49032",
"telephone_number": "269-467-1000",
"fax_number": "269-467-3072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 E. MAIN STREET",
"city": "CENTREVILLE",
"state": "MI",
"postal_code": "49032",
"telephone_number": "269-467-1000",
"fax_number": "269-467-3072"
}
],
"practiceLocations": [
{
"address_1": "451 Health Pkwy Ste B",
"address_purpose": "LOCATION",
"city": "Paw Paw",
"state": "MI",
"postal_code": "490798242",
"country_code": "US",
"telephone_number": "269-655-3065",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FISHER",
"first_name": "JENNIFER",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-14",
"last_updated": "2023-11-27",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801092246",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct.direct@bronsonhg.org",
"affiliation": "Y",
"endpointDescription": "Bronson Healthcare Group Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Continuity of Care Document",
"address_1": "601 John St",
"city": "Kalamazoo",
"state": "MI",
"country_code": "US",
"postal_code": "490075341",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "THICK",
"middle_name": "ROSE",
"credential": "LLMSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Centreville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.