Philip Marinus Koole, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851116202 Issued in MI

Practice address

1165 Hall St SE Apt 2
Grand Rapids, MI 49507-1973

Phone

(616) 265-6265

NPI assigned

May 16, 2023

Sex

Male

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sheri Rodriguez, LMSW, Acsw

  • Counselor
  • Grand Rapids, MI
  • NPI 1245515576
  Medicare reassignment

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1194416735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 HALL ST SE APT 2",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071973",
            "telephone_number": "616-265-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 HALL ST SE APT 2",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071973",
            "telephone_number": "616-265-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOLE",
        "first_name": "PHILIP",
        "middle_name": "MARINUS",
        "name_prefix": "Mr.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851116202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua S Kooistra, DO
• Melissa A Kooistra, PA
• Swanee Kooistra, RN
• Kool Counseling, LLC
• Lucas Koole, LPC
• Kadie Ann Koolwick, DDS
• Eugene Martin Koon, LBSW
• Sarah E.W. Koon, LMHC, LCAC, LPC
• Stormie Koon
• Jonathan William Koons, MD

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.