Individual provider Active NPI

Gloria Klinesteker, LLMSW

  • Clinical Social Worker
  • Port Huron, MI
National Provider Identifier
1992932735
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L1585315 Issued in MI
Practice address
2601 13TH St
Port Huron, MI 48060-6546
Phone
(810) 987-9100
Fax
(810) 987-9105
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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 L1585315 MI Primary

Addresses

Primary practice location

2601 13TH St
Port Huron, MI 48060-6546

Mailing address

2601 13TH St
Port Huron, MI 48060-6546
Phone (810) 987-9100

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
I20140228000841 MI Practitioner - Clinical Social Worker 0547490013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sanilac County Community Mental Health AuthorityGroup PAC ID 0749252062, 19 clinicians

Practice addresses (Care Compare)

110 N Howard Ave
Croswell, MI 48422-1256
Phone (810) 648-0330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L1585315MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanilac County Community Mental Health Authority CurrentSince Dec 14, 2013 Accepting new patients

Locations

110 N Howard Ave
Ste 3
Croswell, MI 48422
Phone (810) 679-4141

110 N Howard Ave
Croswell, MI 48422
Phone (810) 679-4141

227 E Sanilac Rd
Sandusky, MI 48471

217 E Sanilac Rd
Sandusky, MI 48471
Phone (810) 648-4327

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1992932735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 13TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606546",
            "telephone_number": "810-987-9100",
            "fax_number": "810-987-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 13TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606546",
            "telephone_number": "810-987-9100",
            "fax_number": "810-987-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINESTEKER",
        "first_name": "GLORIA",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "L1585315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.