Individual provider Active NPI

Nancy Lynn Dock, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1023266301
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086351 Issued in MI
Practice address
549 Maryland Ave NE
Grand Rapids, MI 49503-2106
Phone
(616) 334-9334
NPI assigned
Aug 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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 6801086351 MI Primary

Addresses

Primary practice location

549 Maryland Ave NE
Grand Rapids, MI 49503-2106

Mailing address

549 Maryland Ave NE
Grand Rapids, MI 49503-2106
Phone (616) 334-9334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201001761 MI Practitioner - Clinical Social Worker 4183904550 Reassigns benefits to 2 organizations
Practice locations: Grand Rapids, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

549 Maryland Ave NE
Grand Rapids, MI 49503-2106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy Dock LLC Clinical CurrentSince Jan 1, 2023 Accepting new patients
Counseling Center of West Michigan, LLC CurrentSince Dec 2, 2019 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

65 S Main St
Ste A
Rockford, MI 49341

Organizations & group practices 3

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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1023266301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 MARYLAND AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032106",
            "telephone_number": "616-334-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 MARYLAND AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032106",
            "telephone_number": "616-334-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCK",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.