Individual provider Active NPI

Brent Alan Parzuchowski

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1013420603
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801108850 Issued in MI
Practice address
550 Cascade West Pkwy SE
Grand Rapids, MI 49546-2137
Phone
(616) 930-4123
Fax
(616) 323-3994
NPI assigned
Nov 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Social Worker 104100000X 6801108850 MI Primary

Addresses

Primary practice location

550 Cascade West Pkwy SE
Grand Rapids, MI 49546-2137

Mailing address

41521 W 11 Mile Rd
Novi, MI 48375-1803

Other practice location 1

41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone (248) 762-3729

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
6801108850MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
616 Counseling Professional Corporation CurrentSince Mar 28, 2021 Accepting new patients
David W Hamilton PSYD PLLC PastSince Mar 28, 2021 Accepting new patients

Locations

550 Cascade West Pkwy SE
Grand Rapids, MI 49546
Phone (616) 930-4123

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1013420603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41521 W 11 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CASCADE WEST PKWY SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462137",
            "telephone_number": "616-930-4123",
            "fax_number": "616-323-3994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41521 W 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751803",
            "country_code": "US",
            "telephone_number": "248-762-3729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARZUCHOWSKI",
        "first_name": "BRENT",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801108850",
            "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 26, 2021; 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.