Kelly Munn, LMSW, CAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801097916 Issued in MI

Practice address

901 Eastern Ave NE
Grand Rapids, MI 49503-1201

Phone

(616) 516-9345

NPI assigned

Mar 18, 2015

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kelly Walker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1225421035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 SUNBROOK ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087708",
            "telephone_number": "616-965-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 EASTERN AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031201",
            "telephone_number": "616-516-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNN",
        "first_name": "KELLY",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-03928",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WALKER",
            "credential": "LMSW, CAADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mazhar Munir, MD
• Laura Maria Muniz, LLMSW
• Sofia Angelita Munk-O'Leary I
• Caleb Munn, LMSW
• Caryn Munn
• Tanya Munoz
• Michaela Maxine Munsee, LLMSW
• Ryan Munsell, M.D.
• Sheri Munsell
• Katherine A Munson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.