Individual provider Active NPI

Cindy Newberry, LMSW

  • Clinical Social Worker
  • Holland, MI
National Provider Identifier
1043786700
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097189 Issued in MI
Practice address
3124 N Wellness Dr Ste 50
Holland, MI 49424-8121
Phone
(616) 805-3660
Fax
(616) 805-3631
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801097189 MI
Clinical Social Worker 1041C0700X 6801097189 MI Primary

Addresses

Primary practice location

3124 N Wellness Dr Ste 50
Holland, MI 49424-8121

Mailing address

333 Bridge St NW Ste 1120
Grand Rapids, MI 49504-5356
Phone (616) 805-3660

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
I20181205000643 MI Practitioner - Clinical Social Worker 0749524502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

3124 N Wellness Dr
Suite 50
Holland, MI 49424-8121
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801097189MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Virtuwell Therapy, LLC CurrentSince Feb 4, 2024 Accepting new patients
Intercare Community Health Network CurrentSince Aug 30, 2021 Accepting new patients
Intercare Community Health Network CurrentSince Aug 30, 2021 Accepting new patients
Counseling Center of West Michigan, LLC CurrentSince Jun 14, 2023 Accepting new patients
Jack a Dekkinga MD PC PastSince Jun 14, 2023 Accepting new patients

Locations

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

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

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

3124 N Wellness Dr
Ste 50
Holland, MI 49424
Phone (616) 263-1678

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

65 S Main St
Ste A
Rockford, MI 49341

Organizations & group practices 5

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1043786700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BRIDGE ST NW STE 1120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045356",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR STE 50",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "CINDY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801097189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.