Individual provider Active NPI

Lisa Ann Bowman, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1295271609
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801079541 Issued in MI
Practice address
4127 Embassy Dr SE
Grand Rapids, MI 49546-2418
Phone
(616) 264-3200
NPI assigned
Jan 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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 6801079541 MI Primary

Addresses

Primary practice location

4127 Embassy Dr SE
Grand Rapids, MI 49546-2418

Mailing address

4127 Embassy Dr SE
Grand Rapids, MI 49546-2418
Phone (616) 264-3200

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
I20211103002443 MI Practitioner - Clinical Social Worker 2769870187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801079541MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Oct 14, 2021 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

325 84th St SW
Ste 103
Byron Center, MI 49315

325 84th St SW
Ste 102
Byron Center, MI 49315

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

3333 Deposit Dr NE
Ste 120
Grand Rapids, MI 49546
Phone (616) 940-3313

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": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1295271609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4127 EMBASSY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462418",
            "telephone_number": "616-264-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4127 EMBASSY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462418",
            "telephone_number": "616-264-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801079541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.