Individual provider Active NPI

Rebecca J Suggitt, LMSW

  • Clinical Social Worker
  • Wyoming, MI
National Provider Identifier
1043359144
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086326 Issued in MI
Practice address
1861 RW Berends Dr SW
Wyoming, MI 49519-4955
Phone
(616) 320-5111
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 61226393 WA
Clinical Social Worker 1041C0700X 6801086326 MI Primary

Addresses

Primary practice location

1861 RW Berends Dr SW
Wyoming, MI 49519-4955

Mailing address

1861 RW Berends Dr SW
Wyoming, MI 49519-4955
Phone (616) 320-5111

Other identifiers 1

IdentifierTypeStateIssuer
4483587MedicaidMI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060123000248 MI Practitioner - Clinical Social Worker 8325062995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Michigan Eating Disorder SpecialistsGroup PAC ID 3577931930, 4 clinicians

Practice addresses (Care Compare)

2905 Wilson Ave SW
Suite 252
Grandville, MI 49418-1206
Phone (616) 320-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61226393WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Eating Disorder Specialists CurrentSince Aug 12, 2022 Accepting new patients

Locations

1861 Rw Berends Dr SW
Wyoming, MI 49519
Phone (616) 259-5387

2905 Wilson Ave SW
Ste 252
Wyoming, MI 49418
Phone (616) 284-1202

Organizations & group practices 1

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1043359144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 RW BERENDS DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194955",
            "telephone_number": "616-320-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 RW BERENDS DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194955",
            "telephone_number": "616-320-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGGITT",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61226393",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4483587",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.