Katie Elizabeth Achtyes, LMSW, CAADC

Individual provider Active NPI Clinical Social Worker · Grand Rapids, MI

NPI 1134429459 · NPPES record last updated Apr 27, 2011

Key facts

NPI
1134429459
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801090605 (MI)
Practice address
201 Sheldon Blvd SE
Grand Rapids, MI 49503-4513
Phone
(616) 459-0255
Fax
(616) 242-6057
NPI assigned
Nov 2, 2010
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6801090605MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Touchstone Innovare Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801090605 MI Yes

Addresses

Primary practice location

201 Sheldon Blvd SE
Grand Rapids, MI 49503-4513

Mailing address

201 Sheldon Blvd SE
Grand Rapids, MI 49503-4513
Phone (616) 459-0255

Other providers in Grand Rapids, MI

All providers in Grand Rapids, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.