Individual provider Active NPI

Grace Thompson, MDIV, LLMSW

  • Clinical Social Worker
  • Holland, MI
National Provider Identifier
1295620300
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851118375 Issued in MI
Practice address
170 College Ave Ste 310
Holland, MI 49423-2982
Phone
(616) 426-9034
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 6851118375 MI Primary

Addresses

Primary practice location

170 College Ave Ste 310
Holland, MI 49423-2982

Mailing address

3424 Chicago Dr Ste 205
Hudsonville, MI 49426-1411
Phone (616) 426-9034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851118375MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Second Story Counseling II LLC CurrentSince Jun 15, 2025 Accepting new patients

Locations

170 College Ave
Ste 310
Holland, MI 49423
Phone (616) 426-9034

3424 Chicago Dr
Ste 205
Hudsonville, MI 49426
Phone (616) 426-9034

Organizations & group practices 1

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": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1295620300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 CHICAGO DR STE 205",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261411",
            "telephone_number": "616-426-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COLLEGE AVE STE 310",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494232982",
            "telephone_number": "616-426-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "GRACE",
        "credential": "MDIV, LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851118375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.