Mary Alice Walker Blanker, LMSW, CAADC, ADS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801093780 Issued in MI

Practice address

1115 Ball Ave, NE
Building C
Grand Rapids, MI 49505-5904

Phone

(616) 459-7215

Fax

(616) 451-0020

NPI assigned

Jul 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Mary Alice Walker Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Stange Clinic, PCGroup PAC ID 1557730603, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Stange Clinic, PC

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1205564531
  Medicare reassignment Care Compare group NPD
• Arbor Circle Corporation

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1174601512
  Medicare reassignment NPD

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1114335817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE, NE",
            "address_2": "BUILDING C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-459-7215",
            "fax_number": "616-451-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE, NE",
            "address_2": "BUILDING C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-459-7215",
            "fax_number": "616-451-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKER",
        "first_name": "MARY ALICE",
        "middle_name": "WALKER",
        "name_prefix": "Mrs.",
        "credential": "LMSW, CAADC, ADS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WALKER",
            "middle_name": "ALICE",
            "prefix": "MS.",
            "credential": "LMSW, CAADC, ADS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachelle Renea Blanchard, PA-C
• Ashley Blanchette, PHARMD
• Lauren Marie Blanck, MD
• Taylor Marie Blank, DNP, FNP-BC
• Emily Laura Blankenship
• Kendall Blanton
• Chloe Blanzy, RN
• Denise Renee Blaser-Gohsman, A.A.S., C.B.I.S.
• Serena Blasko, BEHAVIOR TECHNICIAN
• Brice William Blatz, MD, MS

• 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 Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.