Individual provider Active NPI

Laverna Nicole King-Brown, LLMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1124698014
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3575 Burton St SE # Tau2
Grand Rapids, MI 49546-7681
Phone
(616) 710-1014
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3575 Burton St SE # Tau2
Grand Rapids, MI 49546-7681

Mailing address

1451 Lake Dr SE Unit 68426
Grand Rapids, MI 49516-5058
Phone (810) 814-3000

Other practice location 1

1950 Waldorf St NW Ste E
Grand Rapids, MI 49544-1488
Phone (616) 209-8599

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Huffman Counseling Services Clinical CurrentSince Jul 1, 2021 Accepting new patients
Restoring Dreams Therapy, LLC Clinical CurrentSince Aug 15, 2021 Accepting new patients

Locations

3575 Burton St SE
#2
Grand Rapids, MI 49546
Phone (616) 710-1014

1451 Lake Dr SE
Unit 68426
Grand Rapids, MI 49516

1950 Waldorf St NW
Ste E
Grand Rapids, MI 49544
Phone (616) 209-8599

Organizations & group practices 2

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": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1124698014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 LAKE DR SE UNIT 68426",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495165058",
            "telephone_number": "810-814-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 BURTON ST SE # TAU2",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467681",
            "telephone_number": "616-710-1014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Waldorf St NW Ste E",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495441488",
            "country_code": "US",
            "telephone_number": "616-209-8599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING-BROWN",
        "first_name": "LAVERNA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "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 Aug 11, 2021; 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.