Individual provider Active NPI

Terra Marie Haight, LLMSW

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1215275334
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094995 Issued in MI
Practice address
100 Cherry St SE
Grand Rapids, MI 49503-4526
Phone
(616) 965-8200
Fax
(616) 940-5366
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801094995 MI Primary

Addresses

Primary practice location

100 Cherry St SE
Grand Rapids, MI 49503-4526

Mailing address

1222 Portland Ave NE
Grand Rapids, MI 49505-5248
Phone (616) 458-8478

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

LicenseStateTypeSpecialty
6801094995MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1215275334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 PORTLAND AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055248",
            "telephone_number": "616-458-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034526",
            "telephone_number": "616-965-8200",
            "fax_number": "616-940-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIGHT",
        "first_name": "TERRA",
        "middle_name": "MARIE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094995",
            "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 Jan 24, 2013; 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.