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JACK PINE WELLNESS, PLLC
NPI 1356106348
Social Worker - Clinical in Bad Axe, MI

Active since February 19, 2024
138 HARTSHORN ST, BAD AXE, MI 48413(989) 523-0002 Get Directions Write a Review

NPPES record last updated: June 17, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 17, 2024, Apr 9, 2024 (2 updates tracked since 2024).

About Jack Pine Wellness, Pllc NPPES

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

JACK PINE WELLNESS, PLLC (NPI 1356106348) is a healthcare organization registered as a clinical in Bad Axe, Michigan and active in the NPI registry since February 2024. The organization lists Crysta Ransom-soper, Owner, as its authorized official.

NPPES Registry Identity

NPI1356106348
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameJACK PINE WELLNESS, PLLC
Location Address138 HARTSHORN STBad Axe, MI 48413-1358
Mailing Address138 Hartshorn StBad Axe, MI 48413-1358 · (989) 523-0002
Phone(989) 523-0002
Organization SubpartNo
Authorized OfficialCrysta Ransom-soperOwner · (989) 523-0002
Enumeration DateFebruary 19, 2024
Last NPPES UpdateJune 17, 20242 updates tracked since enumeration
NPPES CertifiedJune 17, 2024
✔ NPI 1356106348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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.
138 HARTSHORN ST, Bad Axe, MI 48413
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Jack Pine Wellness, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jack Pine Wellness, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Crysta Ransom-Soper, LMSW
Clinical Social Worker
NPI 1447797212
6627 ROSE ST
Cass City, MI 48726
(989) 872-1800
✔ PECOS✔ Accepts Medicare16 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 Jack Pine Wellness, PLLC's NPI number?

The NPI number for Jack Pine Wellness, PLLC is 1356106348. It was assigned to this organization in the NPPES registry on February 19, 2024.

Where is Jack Pine Wellness, PLLC located?

Jack Pine Wellness, PLLC is located at 138 Hartshorn St, Bad Axe, MI 48413. The listed phone number is (989) 523-0002.

What is Jack Pine Wellness, PLLC's specialty?

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

Is Jack Pine Wellness, PLLC enrolled in Medicare?

Yes. Jack Pine Wellness, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jack Pine Wellness, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Jack Pine Wellness, PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Jack Pine Wellness, PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Jack Pine Wellness, PLLC 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 Jack Pine Wellness, PLLC was last updated on June 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.