Active NPI
Sarah Lickiss LMSW PLC
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1073269957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Legal business name
- SARAH LICKISS LMSW PLC
- Practice address
- 600 3 Mile Rd NW Ste 101
Grand Rapids, MI 49544-1691 - Phone
- (616) 287-3497
- NPI assigned
- Mar 1, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Beth Houpt
- Title
- Credentialing
- Phone
- (517) 676-9797
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
600 3 Mile Rd NW Ste 101
Grand Rapids, MI 49544-1691
Mailing address
PO Box 10
Mason, MI 48854-0010
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Social Worker
- Grand Rapids, MI
- NPI 1497953434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726099200000",
"number": "1073269957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "MASON",
"state": "MI",
"postal_code": "488540010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 3 MILE RD NW STE 101",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495441691",
"telephone_number": "616-287-3497"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SARAH LICKISS LMSW PLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-01",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A",
"authorized_official_last_name": "HOUPT",
"authorized_official_first_name": "MARY BETH",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "517-676-9797"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"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 Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.