Individual provider Active NPI

Ananya Avinash, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1225639560
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801104718 Issued in MI
Practice address
1403 60TH St SE
Grand Rapids, MI 49508-7065
Phone
(616) 805-3660
Fax
(616) 805-3631
NPI assigned
Nov 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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 6801104718 MI Primary

Addresses

Primary practice location

1403 60TH St SE
Grand Rapids, MI 49508-7065

Mailing address

1403 60TH St SE
Grand Rapids, MI 49508-7065
Phone (616) 805-3660

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210510002118 MI Practitioner - Clinical Social Worker 0446669139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince May 1, 2021 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

1403 60th St SE
Kentwood, MI 49508
Phone (616) 485-9561

65 S Main St
Ste A
Rockford, MI 49341

3800 Lake Michigan Dr NW
Ste 103
Walker, MI 49534
Phone (616) 499-7209

Organizations & group practices 2

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": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1225639560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 60TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 60TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVINASH",
        "first_name": "ANANYA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.