Individual provider Active NPI

Caitlyn Cooney, LLMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1023973419
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851119876 Issued in MI
Practice address
741 Kenmoor Ave SE Ste B
Grand Rapids, MI 49546-2304
Phone
(616) 320-0734
NPI assigned
Dec 18, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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 6851119876 MI Primary

Addresses

Primary practice location

741 Kenmoor Ave SE Ste B
Grand Rapids, MI 49546-2304

Mailing address

741 Kenmoor Ave SE Ste B
Grand Rapids, MI 49546-2304
Phone (616) 320-0734

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
6851119876MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1766016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1023973419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 KENMOOR AVE SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462304",
            "telephone_number": "616-320-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 KENMOOR AVE SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462304",
            "telephone_number": "616-320-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONEY",
        "first_name": "CAITLYN",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-12-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851119876",
            "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 Dec 18, 2025; 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.