Active NPI
Sabreen Rae Polavin, LMSW
- Clinical Social Worker
- Byron Center, MI
National Provider Identifier
1073904579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801097658
- Practice address
- 7791 Byron Center Ave SW
Byron Center, MI 49315-8412 - Phone
- (616) 499-4711
- Fax
- (888) 336-9355
- NPI assigned
- Feb 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801097658 | MI | |
| Clinical Social Worker | 1041C0700X | 6801097658 | MI | Primary |
Addresses
Primary practice location
7791 Byron Center Ave SW
Byron Center, MI 49315-8412
Mailing address
7783 Westminster Dr SW
Byron Center, MI 49315-8550
Phone (734) 846-1771
Other practice location 1
555 Towner St
Ypsilanti, MI 48198-5752
Phone (734) 544-3000
Other practice location 2
385 Leonard St NE
Grand Rapids, MI 49503
Phone (616) 551-0549
Other practice location 3
320 Commerce Ave SW
Grand Rapids, MI 49503-4101
Phone (616) 258-7599
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734048000000",
"number": "1073904579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7783 WESTMINSTER DR SW",
"city": "BYRON CENTER",
"state": "MI",
"postal_code": "493158550",
"telephone_number": "734-846-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7791 BYRON CENTER AVE SW",
"city": "BYRON CENTER",
"state": "MI",
"postal_code": "493158412",
"telephone_number": "616-499-4711",
"fax_number": "888-336-9355"
}
],
"practiceLocations": [
{
"address_1": "555 Towner St",
"address_purpose": "LOCATION",
"city": "Ypsilanti",
"state": "MI",
"postal_code": "481985752",
"country_code": "US",
"telephone_number": "734-544-3000",
"fax_number": "734-544-6732",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "385 Leonard St NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "49503",
"country_code": "US",
"telephone_number": "616-551-0549",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "320 Commerce Ave SW",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495034101",
"country_code": "US",
"telephone_number": "616-258-7599",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLAVIN",
"first_name": "SABREEN",
"middle_name": "RAE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801097658",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801097658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Byron Center, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.