Individual provider Active NPI

Katie Lynne Edson, LMSW, CAADC

  • Clinical Social Worker
  • Muskegon, MI
National Provider Identifier
1134615602
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801102549 Issued in MI
Practice address
700 Terrace Point Dr
Muskegon, MI 49440-1158
Phone
(269) 532-9182
NPI assigned
Jul 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6801102549 MI
Clinical Social Worker 1041C0700X 6801102549 MI Primary

Addresses

Primary practice location

700 Terrace Point Dr
Muskegon, MI 49440-1158

Mailing address

415 Mitzi St Apt 6
North Muskegon, MI 49445-3256
Phone (269) 532-9182

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220601002257 MI Practitioner - Clinical Social Worker 7810375904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unity Counseling LLCGroup PAC ID 7416354949, 20 clinicians

Practice addresses (Care Compare)

5020 E Beltline Ave NE
Suite 202
Grand Rapids, MI 49525-1077
Phone (616) 439-1866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102549MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Counseling LLC Clinical CurrentSince Dec 14, 2023 Accepting new patients

Locations

5020 E Beltline Ave NE
Ste 202
Grand Rapids, MI 49525
Phone (616) 405-0637

700 Terrace Point Dr
Muskegon, MI 49440
Phone (269) 532-9182

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": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1134615602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MITZI ST APT 6",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494453256",
            "telephone_number": "269-532-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 TERRACE POINT DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494401158",
            "telephone_number": "269-532-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSON",
        "first_name": "KATIE LYNNE",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-07",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801102549",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.