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FAMILY SUPPORTIVE SERVICES OF NORTHERN MICHIGAN LLC
NPI 1164943353
Social Worker - Clinical in Cadillac, MI

Active since June 28, 2017
121 N MITCHELL ST, CADILLAC, MI 49601(231) 878-8189(517) 323-9531 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jun 28, 2017 (3 updates tracked since 2017).

About Family Supportive Services Of Northern Michigan Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY SUPPORTIVE SERVICES OF NORTHERN MICHIGAN LLC (NPI 1164943353) is a healthcare organization registered as a clinical in Cadillac, Michigan and active in the NPI registry since June 2017. The organization maintains a secondary practice location in Leroy and lists Jessica Deverman, Owner, as its authorized official.

NPPES Registry Identity

NPI1164943353
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameFAMILY SUPPORTIVE SERVICES OF NORTHERN MICHIGAN LLC
Location Address121 N MITCHELL STCadillac, MI 49601-1879
Mailing Address121 N Mitchell StCadillac, MI 49601-1879 · (231) 878-8189 · Fax (517) 323-9531
Phone(231) 878-8189
Fax(517) 323-9531
Organization SubpartNo
Authorized OfficialJessica DevermanOwner · (231) 878-8189
Enumeration DateJune 28, 2017
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1164943353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MI · 6801095051
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
121 N MITCHELL ST, Cadillac, MI 49601
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Secondary Practice Location 1

Location 119804 15 Mile RdLeRoy, MI 49655-8323 · Phone (231) 878-8189 · Fax (517) 323-9531

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Family Supportive Services Of Northern Michigan Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Family Supportive Services Of Northern Michigan LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Jessica Deverman, LMSW
Clinical Social Worker
NPI 1659952836
114 N MITCHELL ST
Cadillac, MI 49601
(231) 846-4783
✔ PECOS✔ Accepts MedicareSame address
Laura Porter
Mental Health Counselor
NPI 1649758889
114 N MITCHELL ST
Cadillac, MI 49601
(231) 846-4783
✔ PECOS✔ Accepts MedicareSame address
Katie Ranes, LMSW
Clinical Social Worker
NPI 1386355733
114 N MITCHELL ST
Cadillac, MI 49601
(231) 846-4783
✔ PECOS✔ Accepts MedicareSame address
Raya Olson, LMSW
Clinical Social Worker
NPI 1770674921
8691 SUN BAY COURT
Williamsburg, MI 49690
(231) 620-8328
✔ PECOS✔ Accepts Medicare39 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Supportive Services Of Northern Michigan LLC's NPI number?

The NPI number for Family Supportive Services Of Northern Michigan LLC is 1164943353. It was assigned to this organization in the NPPES registry on June 28, 2017.

Where is Family Supportive Services Of Northern Michigan LLC located?

Family Supportive Services Of Northern Michigan LLC is located at 121 N Mitchell St, Cadillac, MI 49601. The listed phone number is (231) 878-8189.

What is Family Supportive Services Of Northern Michigan LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Family Supportive Services Of Northern Michigan LLC enrolled in Medicare?

Yes. Family Supportive Services Of Northern Michigan LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Family Supportive Services Of Northern Michigan LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Family Supportive Services Of Northern Michigan LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (3) and Mental Health Counselor (1). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Family Supportive Services Of Northern Michigan LLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Family Supportive Services Of Northern Michigan LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Family Supportive Services Of Northern Michigan LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.