Individual provider Active NPI

Julia Lynn Vandenbosch, LMSW

  • Clinical Social Worker
  • Kentwood, MI
National Provider Identifier
1215110887
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801064922 Issued in MI
Practice address
3300 36TH St SE
Kentwood, MI 49512-2810
Phone
(616) 831-5582
Fax
(616) 942-0589
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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 6801064922 MI Primary

Addresses

Primary practice location

3300 36TH St SE
Kentwood, MI 49512-2810

Mailing address

8951 Bosworth Dr
Jenison, MI 49428-9464
Phone (616) 831-5582

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson and Wynn Interventions, PLC Clinical PastSince Sep 9, 2014 Accepting new patients
Solace Counseling Services Clinical Past Accepting new patients
Kent County CMH Authority Past Accepting new patients
Spectrum Community Services PastSince Jul 1, 2015 Accepting new patients
Moka Corporation PastSince Oct 1, 2006 Accepting new patients
Thresholds Inc Past Accepting new patients
Spectrum Community Services PastSince Feb 25, 2024 Accepting new patients

Organizations & group practices 7

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": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1215110887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8951 BOSWORTH DR",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289464",
            "telephone_number": "616-831-5582",
            "fax_number": "616-942-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 36TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495122810",
            "telephone_number": "616-831-5582",
            "fax_number": "616-942-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBOSCH",
        "first_name": "JULIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801064922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.