Look up the most recent NPI and PECOS records

Jennifer Nyberg

Social Worker

Behavioral Health & Social Service Providers

20774 Indian St, Southfield, MI 48033-3512

PECOS Enrollment

Based on the most recent information from CMS, provider Jennifer Nyberg is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1659086247
Provider Type
Individual
Full Name
Nyberg, Jennifer
Credential
LMSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/18/2023
Last Updated
1/18/2023

Contact Information

Practice Location

20774 Indian St, Southfield, MI 48033-3512

(734) 709-0887

Unlisted Fax

Mailing Location

20774 Indian St, Southfield, MI 48033-3512

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801114793 Michigan

Jennifer Nyberg

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

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