Blue Anchor Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE ANCHOR BEHAVIORAL HEALTH

Practice address

1550 E Beltline Ave SE Ste 250
Grand Rapids, MI 49506-4364

Phone

(563) 542-2850

NPI assigned

Jun 16, 2022

Last updated

Jun 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Nicole Moskalewski, LMSWNPI 1043737554

Title

Clinical Therapist

Phone

(563) 542-2850

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Nicole Moskalewski, LLMSW

  • Clinical Social Worker
  • Muskegon, MI
  • NPI 1043737554
  NPD Authorized official

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1326778747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11790 HAYMEADOW CT",
            "city": "RAVENNA",
            "state": "MI",
            "postal_code": "494519489",
            "telephone_number": "563-542-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E BELTLINE AVE SE STE 250",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064364",
            "telephone_number": "563-542-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ANCHOR BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "MOSKALEWSKI",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "563-542-2850",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandon Blue
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• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, 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 Jun 21, 2022; 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.