Catholic Charities West Michigan
Organization Active NPI Clinical Social Worker · Grand Rapids, MI
NPI 1245303809 · NPPES record last updated Jan 4, 2012
Key facts
- NPI
- 1245303809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- CATHOLIC CHARITIES WEST MICHIGAN
- Practice address
- 40 Jefferson Ave SE
Grand Rapids, MI 49503-4304 - Phone
- (616) 356-6216
- Fax
- (616) 732-6392
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Deborah J. Nykamp, MSW, ACSW, LMSW
- Title
- Ceo, President
- Phone
- (616) 243-9122
Corporate family (same tax ID) 2
Practitioners 20
-
Kristine Ranae Patterson, LLMSW
-
Traci Elizabeth Ball, LMSW CAADC
-
Rhonda S Byrne, LMSW
-
Margaret J Devries, MSW
-
Christa Marie Galer, LMSW, CAADC, CCS
-
Jeffrey Phillip Hollander, MSW, LMSW
-
Laura Katherine Lucht, LMSW
-
Carlos A Marcano, MD
-
Terry McGovern, MSW, PH.D.
-
Karin McKean, MA
-
Nicholas Pappas, PHD, LPC
-
Valerie A Porenta, LMSW
-
Cheryl Reid, LMSW
-
William R Sutton Jr., LMSW
-
Maria Liberato Tappan, LMSW
-
Cathlene Jean Young, LMSW
-
Kimberly Marie Watkins, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Catholic Charities West Michigan
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
11 Washington St
Hart, MI 49420
Phone (231) 670-6480
456 Century Ln
Holland, MI 49423
Phone (616) 392-2332
355 Settlers Rd
Holland, MI 49423
Phone (616) 667-9551
601 E Washington St
Ste B
Ionia, MI 48846
Phone (616) 522-0836
1095 3rd St
Muskegon, MI 49441
Phone (231) 726-4735
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245303809 | Medicaid | MI |
Other names
- Catholic Social Services
Other providers in Grand Rapids, MI
- Catherine'S Health Center
- Catherine'S Health Center
- Catherines Health Center
- Catherines Health Center
- Alayna T. Cathey
- Catholic Charities West Michigan
- Catholic Charities West Michigan
- Catholic Social Services
- Catholic Social Services
- Brian Catlett
All providers in Grand Rapids, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.