Jack Pine Wellness, PLLC
NPI 1356106348ActiveOrganization· Social Worker, Clinical· Bad Axe, MI
Social Worker, Clinical in Bad Axe, Michigan, registered in NPPES in February 2024. The authorized official on file is Crysta Ransom-Soper, LCSW LMSW, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1356106348 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 19, 2024 |
| Last updated in NPPES | Jun 17, 2024 |
| Certified by provider | Jun 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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All 32 clinical social workers in Bad Axe · All clinical social workers in Michigan