Charissa Ann Jeske-Mahler, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801089971 Issued in MI

Practice address

E23968 Powwow TRL
Watersmeet, MI 49969-0249

Phone

(906) 358-0252

Fax

(906) 358-0254

NPI assigned

May 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lac Vieux Desert Band of Lake Superior Chippewa IndiansGroup PAC ID 2567629181, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Lac Vieux Desert Band of Lake Superior Chippewa Indians

  • Federally Qualified Health Center (FQHC)
  • Watersmeet, MI
  • NPI 1114071578

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1972862852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499690249",
            "telephone_number": "906-358-0252",
            "fax_number": "906-358-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E23968 POWWOW TRL",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499690249",
            "telephone_number": "906-358-0252",
            "fax_number": "906-358-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESKE-MAHLER",
        "first_name": "CHARISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2024-04-03",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01112",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dani Friedley, PHARMD
• Kathleen Giese, LMT, BCTMB
• Robert Hansen, DC
• Jessica Anne Hoffman, FNP
• Kim Ivey, RPH
• Kevin Michael Johnson, FNP
• Lucas A Kunze, MPT
• Lac Vieux Desert Band of Lake Superior Chippewa Indians
• Lac Vieux Desert Band of Lake Superior Chippewa Indians
• Rebecca Larson, DDS

• Clinical Social Worker in Watersmeet, MI
• Providers in Watersmeet, 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 Apr 3, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.