NPIMap

Organization Active NPI

Enlightened Therapy, LLC

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1326691650
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ENLIGHTENED THERAPY, LLC
Practice address
1324 Lake Dr SE Ste 5
Grand Rapids, MI 49506-1673
Phone
(517) 927-8688
NPI assigned
Jul 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Authorized official

Name
Lydia Zuker, LMSW
Title
Owner
Phone
(517) 927-8688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1324 Lake Dr SE Ste 5
Grand Rapids, MI 49506-1673

Mailing address

1324 Lake Dr SE Ste 5
Grand Rapids, MI 49506-1673
Phone (517) 927-8688

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1326691650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKE DR SE STE 5",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061673",
            "telephone_number": "517-927-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKE DR SE STE 5",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061673",
            "telephone_number": "517-927-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLIGHTENED THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "ZUKER",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-927-8688",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Sep 21, 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.