Elizabeth Boshoven LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801081555 Issued in MI

Legal business name

ELIZABETH BOSHOVEN LLC

Practice address

4403 Cascade Road SE
Suite 7
Grand Rapids, MI 49546

Phone

(616) 309-4553

Fax

(616) 469-1078

NPI assigned

May 12, 2014

Last updated

Apr 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Anne Boshoven, LLCNPI 1255401287

Title

Owner

Phone

(616) 309-4553

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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.

• Elizabeth Anne Boshoven, LMSW ACSW

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1255401287
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1093126146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 CASCADE ROAD SE",
            "address_2": "SUITE 7",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-309-4553",
            "fax_number": "616-469-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 CASCADE ROAD SE",
            "address_2": "SUITE 7",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-309-4553",
            "fax_number": "616-469-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH BOSHOVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "BOSHOVEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-309-4553",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LLC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lluvia Elizalde-Diaz
• Hisham Gibriel Bakhiet Elkhider, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.