Kellie Marie Palmbos, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801085935 Issued in MI

Practice address

2100 Raybrook St SE
Grand Rapids, MI 49546-7759

Phone

(616) 540-1673

NPI assigned

Dec 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kellie Marie Brady Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1063984862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4589 EQUESTRIAN DR",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494267493",
            "telephone_number": "616-450-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RAYBROOK ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467759",
            "telephone_number": "616-540-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMBOS",
        "first_name": "KELLIE",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801085935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "BRADY",
            "middle_name": "MARIE",
            "credential": "BSW, MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Palliative Care Medical Associates
• Palm & Panek DDS PC
• Norman V Palm, DDS
• Jamie Lynn Palma, B.S.
• Natalia Palma
• Jill Palmer, NP
• Rachel Ann Palmer
• Rebecca Palmer, BSW
• Michael Palmisano, M.D.
• Anne Marie Palmitier, P.T.

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.