Individual provider Active NPI

Nicole Marie Schaaf, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1194180497
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098414 Issued in MI
Practice address
25 Sheldon Ave SE
Grand Rapids, MI 49503-4209
Phone
(616) 426-3756
NPI assigned
Dec 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801098414 MI Primary

Addresses

Primary practice location

25 Sheldon Ave SE
Grand Rapids, MI 49503-4209

Mailing address

25 Sheldon Ave SE
Grand Rapids, MI 49503-4295
Phone (616) 426-3756

Other practice location 1

385 Leonard Street Northeast
Grand Rapids, MI 49503-9999
Phone (616) 726-5149

Other names 1

  • Nicole Marie Hollebrands Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801098414MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Jun 24, 2019 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Jun 24, 2019 Accepting new patients
Head and Heart Therapeutic Solutions Clinical Past Accepting new patients
Lantern Counseling LLC Past Accepting new patients

Locations

3225 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 364-1500

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 4

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": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1194180497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SHELDON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034295",
            "telephone_number": "616-426-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SHELDON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034209",
            "telephone_number": "616-426-3756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 Leonard Street Northeast",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495039999",
            "country_code": "US",
            "telephone_number": "616-726-5149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAAF",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HOLLEBRANDS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.