Active NPI
Terry Duane Speese, LMSW
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1144311200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801080951
- Practice address
- 1471 Grace St SE
Grand Rapids, MI 49506-1678 - Phone
- (616) 913-2024
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801080951 | MI | Primary |
Addresses
Primary practice location
1471 Grace St SE
Grand Rapids, MI 49506-1678
Mailing address
1471 Grace St SE
Grand Rapids, MI 49506-1678
Phone (616) 913-2024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800D162220 | Other | MI | BC/BS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801080951 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343779200000",
"number": "1144311200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1471 GRACE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495061678",
"telephone_number": "616-913-2024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1471 GRACE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495061678",
"telephone_number": "616-913-2024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEESE",
"first_name": "TERRY",
"middle_name": "DUANE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2012-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801080951",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "800D162220",
"state": "MI"
}
],
"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 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.