Raeana Shante Donaldson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801105600 Issued in MI

Practice address

350 E Michigan Ave Ste 20
Kalamazoo, MI 49007-3848

Phone

(269) 598-2837

NPI assigned

Dec 8, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kalamazoo County Community Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kalamazoo, MI
  • NPI 1710066253

  MI

  Medicare reassignment NPD
• Kalamazoo County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Kalamazoo, MI
  • NPI 1477225506
  NPD
• Healing Conversations Counseling

  • Clinical Social Worker
  • Williamston, MI
  • NPI 1407477698
  NPD (past)

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1013513696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2688 BARKWOOD LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490043723",
            "telephone_number": "269-216-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E MICHIGAN AVE STE 20",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073848",
            "telephone_number": "269-598-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "RAEANA",
        "middle_name": "SHANTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801105600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "350 E Michigan Ave Ste 20",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490073848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Diane Dominas
• Samantha Teresa Dominguez, MD
• Lucas Dominick, PHARM.D.
• Matthew Dommer, M.D.
• Eric Donabedian, RPH
• Danielle Donelson
• Lunden Doney, CRNA
• Lori Dongiovanni
• Emily Sue Dongvillo, RD
• Ashley Donham, LLP

• All providers in Kalamazoo, MI
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.