NPIMap

Organization Active NPI

Catholic Charities West Michigan

Doing business as Catholic Social Services

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1245303809
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CATHOLIC CHARITIES WEST MICHIGAN
Doing business as
Catholic Social Services
Practice address
40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Phone
(616) 356-6216
Fax
(616) 732-6392
NPI assigned
Nov 15, 2006
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Deborah J. Nykamp, MSW, ACSW, LMSW
Title
Ceo, President
Phone
(616) 243-9122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

40 Jefferson Ave SE
Grand Rapids, MI 49503-4304

Mailing address

40 Jefferson
Grand Rapids, MI 49503
Phone (616) 456-1443

Other names 1

  • Catholic Social Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100329001062 MI Part B Supplier - Clinic/Group Practice 9234265216 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI; Holland, MI; Ionia, MI; Muskegon, MI

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities West Michigan3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

212 Maple St
Big Rapids, MI 49307
Phone (231) 796-1583

605 S 3rd Ave
Ste Aa
Big Rapids, MI 49307
Phone (231) 796-1583

355 Settlers Rd
Holland, MI 49423
Phone (616) 667-9551

456 Century Ln
Holland, MI 49423
Phone (616) 392-2332

601 E Washington St
Ste B
Ionia, MI 48846
Phone (616) 522-0836

1095 3rd St
Muskegon, MI 49441
Phone (231) 726-4735

2660 44th St SW
Wyoming, MI 49519
Phone (616) 261-5638

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1245303809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 JEFFERSON",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-456-1443",
            "fax_number": "616-732-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034304",
            "telephone_number": "616-356-6216",
            "fax_number": "616-732-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES WEST MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "NYKAMP",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "616-243-9122",
        "authorized_official_credential": "MSW, ACSW, LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Social Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.