NPIMap

Organization Active NPI

Arbor Circle Corporation

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1174601512
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ARBOR CIRCLE CORPORATION
Practice address
1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone
(616) 456-7775
Fax
(616) 456-8568
NPI assigned
Nov 2, 2006
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Cathy Cardosa
Title
Human Resources Manager
Phone
(616) 456-7775

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003749 MI
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Clinical Child & Adolescent Psychologist 103TC2200X NU
Clinical Social Worker 1041C0700X NU Primary
Marriage & Family Therapist 106H00000X NU
Addiction Medicine (Internal Medicine) Physician 207RA0401X 4301034105 MI
Developmental - Behavioral Pediatrics Physician 2080P0006X 4301069203 MI
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Mailing address

1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone (616) 456-7775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000708 MI Part B Supplier - Clinic/Group Practice 2668362393 Receives reassigned benefits from 34 practitioners
Practice locations: Grand Rapids, MI; Sparta, MI; Rockford, MI; Newaygo, MI

National Provider Directory

National Provider Directory
Tax ID family
Arbor Circle Corporatio8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1115 Ball Ave NE
Bldg C
Grand Rapids, MI 49505
Phone (616) 459-7215

1331 Lake Dr SE
Grand Rapids, MI 49506
Phone (616) 459-7215

412 Century Ln
Holland, MI 49423
Phone (616) 396-2301

848 E Lincoln Ave
Ionia, MI 48846
Phone (616) 527-0200

232 E 82nd St
Newaygo, MI 49337
Phone (231) 652-1760

10075 Northland Dr NE
Rockford, MI 49341
Phone (616) 632-7250

1611 12 Mile Rd NW
Sparta, MI 49345
Phone (616) 887-3633

308 E Main St
Stanton, MI 48888
Phone (517) 831-4980

740 36th St SE
Wyoming, MI 49548
Phone (616) 475-8300

Practitioners & affiliated clinicians

Practitioners 245

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 245

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1174601512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-456-7775",
            "fax_number": "616-456-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-456-7775",
            "fax_number": "616-456-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR CIRCLE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "CARDOSA",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "HUMAN RESOURCES MANAGER",
        "authorized_official_telephone_number": "616-456-7775"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003749",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4301034105",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "MI",
            "license": "4301069203",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.