Individual provider Active NPI

Rebecca McDaniel

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1306207881
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114859 Issued in MI
Practice address
40 Pearl St NW Ste 341
Grand Rapids, MI 49503-3026
Phone
(708) 420-4989
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149018251 IL
Clinical Social Worker 1041C0700X C012553 NC
Clinical Social Worker 1041C0700X 6801114859 MI Primary

Addresses

Primary practice location

40 Pearl St NW Ste 341
Grand Rapids, MI 49503-3026

Mailing address

309 Woodmere Ave SE
Grand Rapids, MI 49506-1724
Phone (708) 420-4989

Other practice location 1

383 Merrimon Ave
Asheville, NC 28801-1223
Phone (708) 420-4989

Other practice location 2

2040 N Milwaukee Ave
Suite 9
Chicago, IL 60647-4002
Phone (773) 273-9149

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801114859MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Counseling LLC Clinical Current Accepting new patients
Peak Counseling, LLC Clinical Current Accepting new patients

Locations

40 Pearl St NW
Ste 341
Grand Rapids, MI 49503
Phone (616) 485-7082

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1306207881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 WOODMERE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061724",
            "telephone_number": "708-420-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PEARL ST NW STE 341",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033026",
            "telephone_number": "708-420-4989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "383 Merrimon Ave",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288011223",
            "country_code": "US",
            "telephone_number": "708-420-4989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 N Milwaukee Ave",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606474002",
            "country_code": "US",
            "telephone_number": "773-273-9149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018251",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012553",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.