Kelsey Devries, LMSW, CAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801102459 Issued in MI

Practice address

2450 Van Ommen Dr
Holland, MI 49424-8085

Phone

(616) 350-7781

NPI assigned

May 16, 2018

Sex

Female

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

Other names 1

• Kelsey Anderson Former name

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1326538133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 VAN OMMEN DR STE C",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248085",
            "telephone_number": "616-295-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 VAN OMMEN DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248085",
            "telephone_number": "616-350-7781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2416 Peck St",
            "address_purpose": "LOCATION",
            "city": "Muskegon Heights",
            "state": "MI",
            "postal_code": "494441431",
            "country_code": "US",
            "telephone_number": "231-286-0698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "KELSEY",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326538133",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel A Dethmers, MD
• Jacquelyn Deur
• Developmental Enhancement
• Developmental Enhancement, PLC
• David Lee Devisser, MD
• Jessica L Dew
• Kerri L Deweerdt, COTA
• Kristin Janette Dewitt, LLMSW
• Lara Dewitt, M.ED, SCL
• Rachael Dewitt

• Clinical Social Worker in Holland, MI
• Providers in Holland, 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 Jul 20, 2021; 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.