Keith Vandyke, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801035950 Issued in MI

Practice address

125 E Southern Ave
Muskegon, MI 49442-5041

Phone

(231) 724-3699

Fax

(231) 724-3659

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1316045255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 E APPLE AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494423466",
            "telephone_number": "231-724-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E SOUTHERN AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425041",
            "telephone_number": "231-724-3699",
            "fax_number": "231-724-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801035950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "KV035950",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trent Joseph Vanderstelt, CPED
• Amber Lynn Vanderwagen, AGACNP-BC
• Kent W Vandevrede, DO
• Kellen Vandreumel, PHARM.D.
• Shelley A Vandusen, RN
• Linda M Vandyke, PT
• Barbara Ann Vanfossen, LBSW
• Kristen N Vanhouten
• Laverne W Vanhouten, MA
• Troy Vanhouten

• Clinical Social Worker in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.