Individual provider Active NPI

Angela Chesser, LLMSW

  • Clinical Social Worker
  • Kentwood, MI
National Provider Identifier
1083964530
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801100329 Issued in MI
Practice address
1715 Sutherland Dr SE
Kentwood, MI 49508-3306
Phone
(616) 281-4601
Fax
(616) 281-9572
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801100329 MI
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 6801100329 MI Primary

Addresses

Primary practice location

1715 Sutherland Dr SE
Kentwood, MI 49508-3306

Mailing address

1715 Sutherland Dr SE
Kentwood, MI 49508-3306
Phone (616) 281-4601

Other practice location 1

5239 S Roosevelt Rd
Stevensville, MI 49127-9504
Phone (269) 921-7301

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

State licenses

LicenseStateTypeSpecialty
6801100329MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Chesser LLC Clinical Current Accepting new patients

Locations

800 Monroe Ave NW
Ste 320
Grand Rapids, MI 49503
Phone (616) 558-6295

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1083964530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 SUTHERLAND DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495083306",
            "telephone_number": "616-281-4601",
            "fax_number": "616-281-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 SUTHERLAND DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495083306",
            "telephone_number": "616-281-4601",
            "fax_number": "616-281-9572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5239 S Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MI",
            "postal_code": "491279504",
            "country_code": "US",
            "telephone_number": "269-921-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHESSER",
        "first_name": "ANGELA",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801100329",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.