Individual provider Active NPI

Craig R McLean, LMSW

  • Social Worker
  • Royal Oak, MI
National Provider Identifier
1992816474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801003848 Issued in MI
Practice address
30701 Woodward Ave
#200
Royal Oak, MI 48073-0987
Phone
(248) 288-9333
Fax
(248) 288-1362
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801003848 MI Primary

Addresses

Primary practice location

30701 Woodward Ave
#200
Royal Oak, MI 48073-0987

Mailing address

28000 Dequindre Rd
Warren, MI 48092-2468
Phone (586) 753-0405

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
I20110110000666 MI Practitioner - Clinical Social Worker 2062318462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801003848MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Eastwood Behavioral Health Social Worker CurrentSince Mar 2, 2020 Accepting new patients

Locations

17250 Farmington Rd
Livonia, MI 48152
Phone (734) 425-4070

30701 Woodward Ave
Ste 200
Royal Oak, MI 48073
Phone (248) 288-9333

2800 Livernois Rd
Ste 500
Troy, MI 48083
Phone (586) 753-0400

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992816474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0405",
            "fax_number": "586-753-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30701 WOODWARD AVE",
            "address_2": "#200",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730987",
            "telephone_number": "248-288-9333",
            "fax_number": "248-288-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "CRAIG",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801003848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.