Individual provider Active NPI

Kimberly Dawn Stratton, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1275805756
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088137 Issued in MI
Practice address
360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214
Phone
(616) 805-3660
Fax
(616) 805-3631
NPI assigned
Jan 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 6801088137 MI Primary

Addresses

Primary practice location

360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214

Mailing address

360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214
Phone (616) 805-3660

Other practice location 1

100 Cherry St SE
Grand Rapids, MI 49503-4526
Phone (616) 965-8200 ext. 7113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191009002297 MI Practitioner - Clinical Social Worker 6406187236 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088137MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Sep 18, 2019 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

65 S Main St
Ste A
Rockford, MI 49341

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1275805756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061214",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061214",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Cherry St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034526",
            "country_code": "US",
            "telephone_number": "616-965-8200 x7113",
            "fax_number": "616-940-5366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRATTON",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.