Individual provider Active NPI

Kia Shaveen Jones-Mastin, LMSW

  • Social Worker
  • Saginaw, MI
National Provider Identifier
1982881017
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801089366 Issued in MI
Practice address
3115 Mackinaw St
Saginaw, MI 48602-3221
Phone
(989) 399-5940
Fax
(989) 399-8261
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801106546 MI
Social Worker 104100000X 6801089366 MI Primary

Addresses

Primary practice location

3115 Mackinaw St
Saginaw, MI 48602-3221

Mailing address

501 Lapeer Ave
Saginaw, MI 48607-1203
Phone (989) 759-6464

Other practice location 1

3253 Congress Ave
Saginaw, MI 48602-3106
Phone (989) 475-4171

Other identifiers 1

IdentifierTypeStateIssuer
730195MedicaidMI

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

LicenseStateTypeSpecialty
6801089366MIMDSocial Worker
6801106546MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1982881017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 MACKINAW ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023221",
            "telephone_number": "989-399-5940",
            "fax_number": "989-399-8261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3253 Congress Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486023106",
            "country_code": "US",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES-MASTIN",
        "first_name": "KIA",
        "middle_name": "SHAVEEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106546",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801089366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730195",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.