NPIMap

Individual provider Active NPI

Kimberly Belle Lavender, LMSW

  • Social Worker
  • Greenville, MI
National Provider Identifier
1285985358
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801093841 Issued in MI
Practice address
309 1/2 S Lafayette St Ste 202
Greenville, MI 48838
Phone
(616) 835-9292
Fax
(616) 835-9293
NPI assigned
Sep 28, 2012
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801093841 MI Primary

Addresses

Primary practice location

309 1/2 S Lafayette St Ste 202
Greenville, MI 48838

Mailing address

PO Box 10
Mason, MI 48854-0010

Other identifiers 1

IdentifierTypeStateIssuer
1715928MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102001251 MI Practitioner - Clinical Social Worker 8628149614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093841MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly B Lavender, LLC Social Worker CurrentSince Nov 25, 2014 Accepting new patients
Sinclaire Solutions LLC Social Worker Past Accepting new patients
Cherry Street Services, Inc Clinical PastSince Oct 1, 2011 Accepting new patients

Locations

309 S Lafayette St
Ste 202
Greenville, MI 48838
Phone (616) 232-6935

Ownership & related parties

All facility ownership & control disclosures 20

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heart of the City Health CenterGrand Rapids, MI, CCN 231887 Federally qualified health center Corporate Director Nov 3, 2008
Montcalm Area Health CenterGreenville, MI, CCN 231930 Federally qualified health center Corporate Director (1%) Apr 3, 2008
Burton Health CenterGrand Rapids, MI, CCN 231852 Federally qualified health center Corporate Director (1%) Aug 6, 2010
Westside Health CenterGrand Rapids, MI, CCN 231853 Federally qualified health center Corporate Director (1%) Dec 1, 2007
Cherry Street Health ServicesGrand Rapids, MI, CCN 231809 Federally qualified health center Corporate Director (1%) Dec 1, 2007
Southside Health CenterGrand Rapids, MI, CCN 231970 Federally qualified health center Corporate Officer Oct 1, 2011
Wyoming Community Health CenterWyoming, MI, CCN 231986 Federally qualified health center Corporate Officer Oct 1, 2011
Ottawa Hills High School Health CenterGrand Rapids, MI, CCN 231909 Federally qualified health center Corporate Director Dec 1, 2007
Union High School Health CenterGrand Rapids, MI, CCN 231879 Federally qualified health center Corporate Director Dec 1, 2007
Cedar Springs Middle School Health CenterCedar Springs, MI, CCN 231056 Federally qualified health center Corporate Director (1%) Apr 1, 2015
Innovation Central High School Health CenterGrand Rapids, MI, CCN 231101 Federally qualified health center Corporate Director Sep 8, 2016
Muskegon Recovery CenterMuskegon, MI, CCN 231103 Federally qualified health center Corporate Director Nov 30, 2016
Barry Community Health CenterHastings, MI, CCN 231122 Federally qualified health center Corporate Director Nov 30, 2016
Wyoming Junior High School Health CenterWyoming, MI, CCN 231159 Federally qualified health center Corporate Director Mar 18, 2020
Godwin Heights Middle SchoolGrand Rapids, MI, CCN 231165 Federally qualified health center Corporate Director Sep 29, 2020
Southside Health Center Suite 200Grand Rapids, MI, CCN 231176 Federally qualified health center Corporate Director Nov 1, 2021
Lakeside ClubhouseHolland, MI, CCN 231196 Federally qualified health center Corporate Director Jan 2, 2019
Godwin Heights Senior High School Health CenterGrand Rapids, MI, CCN C71006 Federally qualified health center Corporate Director Aug 14, 2023
Cherry Health - Cedar Springs High School Health CenterCedar Springs, MI, CCN C71024 Federally qualified health center Corporate Director May 8, 2024
Cherry Health Tri County Middle SchoolHoward City, MI, CCN C71028 Federally qualified health center Corporate Director Jul 22, 2024

Owned or controlled facilities with NPI records 20

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 20

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1285985358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 1/2 S LAFAYETTE ST STE 202",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "48838",
            "telephone_number": "616-835-9292",
            "fax_number": "616-835-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "KIMBERLY",
        "middle_name": "BELLE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801093841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1715928",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

Verify at the official NPI Registry.