Active NPI
Christie Custer, LMSW
- Clinical Social Worker
- Allendale, MI
National Provider Identifier
1225410764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801080804
- Practice address
- 11304 Edgewater Dr
Suite D
Allendale, MI 49401-8499 - Phone
- (616) 892-1070
- Fax
- (616) 892-1073
- NPI assigned
- Jun 21, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801080804 | MI | Primary |
Addresses
Primary practice location
11304 Edgewater Dr
Suite D
Allendale, MI 49401-8499
Mailing address
11304 Edgewater Dr
Suite D
Allendale, MI 49401-8499
Phone (616) 892-1070
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801080804 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solace Counseling Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Allendale, MI
- NPI 1205187093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434844800000",
"number": "1225410764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11304 EDGEWATER DR",
"address_2": "SUITE D",
"city": "ALLENDALE",
"state": "MI",
"postal_code": "494018499",
"telephone_number": "616-892-1070",
"fax_number": "616-892-1073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11304 EDGEWATER DR",
"address_2": "SUITE D",
"city": "ALLENDALE",
"state": "MI",
"postal_code": "494018499",
"telephone_number": "616-892-1070",
"fax_number": "616-892-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSTER",
"first_name": "CHRISTIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-21",
"last_updated": "2015-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801080804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allendale, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.