Active NPI
Tyreanna Odren
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1164318416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6851117960
- Practice address
- 300 68TH St SE
Grand Rapids, MI 49548-6927 - Phone
- (616) 455-5000
- Fax
- (616) 455-5960
- NPI assigned
- Jun 14, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6851117960 | MI | Primary |
Addresses
Primary practice location
300 68TH St SE
Grand Rapids, MI 49548-6927
Mailing address
1415 Prairie Pkwy SW Unit 116
Wyoming, MI 49509-2793
Phone (616) 385-8235
Other practice location 1
2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458
Phone (616) 217-9421
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 |
|---|---|---|---|
| 6851117960 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766448000000",
"number": "1164318416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 PRAIRIE PKWY SW UNIT 116",
"city": "WYOMING",
"state": "MI",
"postal_code": "495092793",
"telephone_number": "616-385-8235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5000",
"fax_number": "616-455-5960"
}
],
"practiceLocations": [
{
"address_1": "2920 Fuller Ave NE Ste 203",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495053458",
"country_code": "US",
"telephone_number": "616-217-9421",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODREN",
"first_name": "TYREANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-14",
"last_updated": "2025-12-23",
"certification_date": "2025-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6851117960",
"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 Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.