Individual provider Active NPI

Larry Lynn Sonksen, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1295928869
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801007295 Issued in MI
Practice address
2020 Raybrook St SE
Suite 306
Grand Rapids, MI 49546-7717
Phone
(616) 942-8544
Fax
(616) 942-8544
NPI assigned
Aug 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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 6801007295 MI Primary

Addresses

Primary practice location

2020 Raybrook St SE
Suite 306
Grand Rapids, MI 49546-7717

Mailing address

2020 Raybrook St SE
Suite 306
Grand Rapids, MI 49546-7717
Phone (616) 942-8544

Other identifiers 2

IdentifierTypeStateIssuer
8008928970OtherMIBC/BS OF MI
350026OtherMIMANAGED HEALTH NETWORK

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
I20120319000354 MI Practitioner - Clinical Social Worker 4284893876 Practice locations: Grand Rapids, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2020 Raybrook St SE
Suite 104a
Grand Rapids, MI 49546-7717
Phone (616) 706-7610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801007295MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1295928869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE",
            "address_2": "SUITE 306",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-942-8544",
            "fax_number": "616-942-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE",
            "address_2": "SUITE 306",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-942-8544",
            "fax_number": "616-942-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONKSEN",
        "first_name": "LARRY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801007295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MI",
            "identifier": "8008928970",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "350026",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.