Jaclyn Michelle Abbate, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801099351 Issued in MI

Practice address

1525 E Beltline Ave NE Ste 204
Grand Rapids, MI 49525-4598

Phone

(616) 965-1200

Fax

(616) 288-9045

NPI assigned

May 31, 2016

Last updated

Feb 21, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clearwater Counseling & Wellness LLC

  • Psychologist
  • Grand Rapids, MI
  • NPI 1720529332
  NPD

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1144678210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E BELTLINE AVE NE STE 204",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254598",
            "telephone_number": "616-965-1200",
            "fax_number": "616-288-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E BELTLINE AVE NE STE 204",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254598",
            "telephone_number": "616-965-1200",
            "fax_number": "616-288-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBATE",
        "first_name": "JACLYN",
        "middle_name": "MICHELLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Abada
• Ivan Joseph Abadines
• Roki Ann Abakoui, PH.D.
• Allison Abaunza
• Shan E Abbas, M.D.
• Nicholas Thomas Abbey, MD
• Nicole Renee Abbgy, NP
• Stacie Lyn Abbitt, COTA
• Kierstin Abbott
• Stephanie Abbott, PA-C

• 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 21, 2020; 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.