CREEKSIDE COUNSELING GROUP LLC – Clinical Social Worker, NPI 1619550860
Clinical Social Worker
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CREEKSIDE COUNSELING GROUP LLC
15173 North Rd Ste 100
Fenton, MI 484301381
Phone: (810) 771-4074
Fax: (810) 866-4450
Type: Location
7227 Fenton Rd
Grand Blanc, MI 484398961
Phone: (810) 771-4074
Fax: (810) 866-4450
Type: Location
10683 S SAGINAW ST STE B
GRAND BLANC, MI 484398127
Phone: (810) 771-4074
Fax: (810) 866-4450
Type: Mailing
9056 NEWCASTLE CT
GRAND BLANC, MI 484397346
Phone: (810) 422-3708
Type: Mailing
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: 2021-07-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (52 days away).
Enrollment records
1
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20210713000742 | O | Clinic/Group Practice | MI | 2026-07-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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 48430)
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