Great Lakes Hope LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GREAT LAKES HOPE LLC

Practice address

2687 Odawa TRL
Muskegon, MI 49444-6739

Phone

(231) 670-7416

NPI assigned

Oct 20, 2020

Last updated

Apr 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jessica Elizabeth Bennett, LMSWNPI 1306184684

Title

Member

Phone

(231) 670-7416

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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.

• Jessica E Bennett, LMSW

  • Clinical Social Worker
  • Ludington, MI
  • NPI 1306184684
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1275132441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 ODAWA TRL",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494446739",
            "telephone_number": "231-670-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2687 ODAWA TRL",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494446739",
            "telephone_number": "231-670-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HOPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "231-670-7416",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Graves, LMSW
• Michelle Lynne Gravlin, OTR
• Carrie J Gray, LMSW
• Kathleen Marie Gray, PA
• Shakia Gray
• Great Lakes Internal Medicine, PC
• Great Lakes OBGYN Specialist
• Great Lakes Obstetric Gynecological Specialists PLC
• Great Lakes Specialty Hosptial - Hackley LLC (Select Specialty Hospital - Muskegon)
• Greater Grace Assemblies and Networks (Open Gates of Grace)

• Clinical Social Worker in Muskegon, MI
• Providers in Muskegon, 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 Apr 7, 2021; 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.