Kathryn Lynne Hickok Mannebach, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091668 Issued in MI

Practice address

300 68TH St SE
Grand Rapids, MI 49548-6927

Phone

(269) 330-4963

NPI assigned

Jun 15, 2018

Last updated

Jun 22, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Meier Clinics of Illinois, P.C.

  dba Meier Clinics

  • Professional Counselor
  • Chicago, IL
  • NPI 1679529283
  NPD (past)

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1245724020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 DIAMOND AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033602",
            "telephone_number": "269-330-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "269-330-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKOK MANNEBACH",
        "first_name": "KATHRYN",
        "middle_name": "LYNNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy G Hibma, MSW ACSW
• Hannah Marko Hickey
• Patricia Ann Hickey, LMSW, CSW
• Gabriela Hickman
• Jaclyn Hickmott
• Sharon K. Hickox, AUD, MA, CCC-A
• Khadaija Roberta Hicks
• Natalie Carol Hicks
• Claire Hickson
• Matthew Hickson

• 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 Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.