Individual provider Active NPI

Victoria Fisher, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1255704532
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098998 Issued in MI
Practice address
1121 Broadway Ave NW Apt 2
Grand Rapids, MI 49504-4215
Phone
(517) 677-1233
NPI assigned
Nov 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 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 6801098998 MI Primary

Addresses

Primary practice location

1121 Broadway Ave NW Apt 2
Grand Rapids, MI 49504-4215

Mailing address

1971 E Beltline Ave NE Ste 106-812
Grand Rapids, MI 49525-7045
Phone (616) 259-6227

Other practice location 1

3353 Lousma Dr SE
Wyoming, MI 49548-2251
Phone (616) 241-6258 ext. 135

Other practice location 2

385 Leonard St NE
Grand Rapids, MI 49503-1129
Phone (616) 454-4777 ext. 15140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1255704532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 E BELTLINE AVE NE STE 106-812",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257045",
            "telephone_number": "616-259-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 BROADWAY AVE NW APT 2",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044215",
            "telephone_number": "517-677-1233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3353 Lousma Dr SE",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495482251",
            "country_code": "US",
            "telephone_number": "616-241-6258 x135",
            "fax_number": "616-241-6470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "385 Leonard St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495031129",
            "country_code": "US",
            "telephone_number": "616-454-4777 x15140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "VICTORIA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 4, 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.