Individual provider Active NPI

Lenin Thomas

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1013300557
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086866 Issued in MI
Practice address
790 Fuller NE
Grand Rapids, MI 49503
Phone
(616) 304-7768
NPI assigned
Mar 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801086866 MI Primary

Addresses

Primary practice location

790 Fuller NE
Grand Rapids, MI 49503

Mailing address

21540 Provincial Blvd
Apt- 2518
Katy, TX 77450
Phone (616) 304-7768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801086866MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1013300557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21540 PROVINCIAL BLVD",
            "address_2": "APT- 2518",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77450",
            "telephone_number": "616-304-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 FULLER NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-304-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LENIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.