Individual provider Active NPI

Kristy Keever, LMSW

  • Clinical Social Worker
  • Grand Haven, MI
National Provider Identifier
1063199677
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114574 Issued in MI
Practice address
41 Washington Ave Ste 368
Grand Haven, MI 49417-1378
Phone
(231) 638-1925
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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 6801114574 MI Primary

Addresses

Primary practice location

41 Washington Ave Ste 368
Grand Haven, MI 49417-1378

Mailing address

41 Washington Ave Ste 368
Grand Haven, MI 49417-1378

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
6801114574MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Counseling and Wellness, LLC Clinical Current Accepting new patients

Locations

41 Washington Ave
Ste 368
Grand Haven, MI 49417
Phone (616) 638-8830

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1063199677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 368",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 368",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171378",
            "telephone_number": "231-638-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEVER",
        "first_name": "KRISTY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.