Individual provider Active NPI

Caroline Kennedy, MSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1972059236
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092939 Issued in MI
Practice address
2245 S. State St.
Suite 200
Ann Arbor, MI 48104-6184
Phone
(734) 769-0209
Fax
(734) 769-0224
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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 6801092939 MI Primary

Addresses

Primary practice location

2245 S. State St.
Suite 200
Ann Arbor, MI 48104-6184

Mailing address

2245 S State St
Suite 200
Ann Arbor, MI 48104-6184
Phone (734) 769-0209

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
I20160920002782 MI Practitioner - Clinical Social Worker 8729375621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Family Services of Washtenaw County IncGroup PAC ID 2769671106, 8 clinicians

Practice addresses (Care Compare)

2245 S State St
Suite 200
Ann Arbor, MI 48104-6184
Phone (734) 769-0209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092939MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Services of Washtenaw County, Inc. Clinical CurrentSince Aug 30, 2016 Accepting new patients

Locations

2245 S State St
Ste 200
Ann Arbor, MI 48104
Phone (734) 769-0209

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1972059236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 S STATE ST",
            "address_2": "SUITE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046184",
            "telephone_number": "734-769-0209",
            "fax_number": "734-769-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 S. STATE ST.",
            "address_2": "SUITE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046184",
            "telephone_number": "734-769-0209",
            "fax_number": "734-769-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CAROLINE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.