MRS. JACQUELINE ANNE KABA (LMSW) – Clinical Social Worker, NPI 1104160837

MRS. JACQUELINE ANNE KABA (LMSW) is a healthcare provider. based in Southfield, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801082363 (MI). The NPI Number for MRS. JACQUELINE ANNE KABA (LMSW) is 1104160837

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JACQUELINE ANNE KABA (LMSW)
NPI
1104160837
Phone
(646) 492-0629
Address
28475 GREENFIELD RD
Enumeration Date
19 November 2012
Last Update Date
25 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7347857700
Graduation Year
2001 (25 years ago)
PAC ID
7911291851
Group Practice PAC ID
8022171735
Professional Enrollment ID
I20170317000093
Address ID
MI481952216SO13101RDXX300

Contacts

Secure Messaging
pcerecords.essmichigan@direct.mihin.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:13State licenses:1Other namesUpdated within 12 months

4,820 CLINICAL SOCIAL WORKER in MI

Provider Addresses for MRS. JACQUELINE ANNE KABA (LMSW)

  • 28475 GREENFIELD RD

    SOUTHFIELD, MI 480763034

    Phone: (646) 492-0629

    Type: Location

  • 9045 KINLOCH

    REDFORD, MI 482391885

    Phone:

    Type: Mailing

  • 20300 SUPERIOR RD STE 200

    TAYLOR, MI 481806303

    Phone: (734) 785-7700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-03-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170317000093IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48076)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022171735View full group profile
NameSpecialtyState
Mental Health CounselorMI
Clinical Social WorkerMI
P S Y C H I A T R YMI
P S Y C H I A T R YMI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

How do payers reference MRS. JACQUELINE ANNE KABA (LMSW)?
For MRS. JACQUELINE ANNE KABA (LMSW), use NPI 1104160837 as the unique 10-digit identifier.
Is there an active status for MRS. JACQUELINE ANNE KABA (LMSW)?
For scheduling context, MRS. JACQUELINE ANNE KABA (LMSW) is shown as active in the registry.
What area of care is associated with MRS. JACQUELINE ANNE KABA (LMSW)?
MRS. JACQUELINE ANNE KABA (LMSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is MRS. JACQUELINE ANNE KABA (LMSW) located near Southfield?
MRS. JACQUELINE ANNE KABA (LMSW) currently maps to Southfield, Michigan in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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