Individual provider Active NPI

Ashley Anne Paxson, LMSW

  • Clinical Social Worker
  • Grandville, MI
National Provider Identifier
1295305464
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801112371 Issued in MI
Practice address
4250 Chicago Dr SW Ste B
Grandville, MI 49418-1506
Phone
(616) 805-3660
Fax
(616) 805-3631
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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 6801112371 MI Primary

Addresses

Primary practice location

4250 Chicago Dr SW Ste B
Grandville, MI 49418-1506

Mailing address

333 Bridge St NW Ste 1120
Grand Rapids, MI 49504-5356
Phone (616) 805-3660

Other practice location 1

4150 Kalamazoo Ave SE
Grand Rapids, MI 49508-3605
Phone (616) 913-2006

Other names 1

  • Ashley Anne Heitzman Former name

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
I20231101000204 MI Practitioner - Clinical Social Worker 1759737497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801112371MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Care Resources CurrentSince Sep 5, 2023 Accepting new patients
Counseling Center of West Michigan, LLC CurrentSince Sep 30, 2023 Accepting new patients
Virtuwell Therapy, LLC CurrentSince Feb 4, 2024 Accepting new patients

Locations

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (269) 808-7198

4150 Kalamazoo Ave SE
Grand Rapids, MI 49508
Phone (616) 913-2006

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

4250 Chicago Dr SW
#B
Grandville, MI 49418
Phone (269) 419-2392

65 S Main St
Ste A
Rockford, MI 49341

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1295305464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BRIDGE ST NW STE 1120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045356",
            "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": "4250 CHICAGO DR SW STE B",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181506",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 Kalamazoo Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495083605",
            "country_code": "US",
            "telephone_number": "616-913-2006",
            "fax_number": "616-913-2005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAXSON",
        "first_name": "ASHLEY",
        "middle_name": "ANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801112371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "HEITZMAN",
            "middle_name": "ANNE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.