Individual provider Active NPI

Theresa Stevens, LMSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1346708450
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110146 Issued in MI
Practice address
1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone
(269) 226-7000
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801110146 MI Primary

Addresses

Primary practice location

1521 Gull Rd
Kalamazoo, MI 49048-1640

Mailing address

544 Lawrence Ave
Wayland, MI 49348-1474
Phone (269) 271-6343

Other names 1

  • Theresa Rutgers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707001297 MI Practitioner - Clinical Social Worker 5193127637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801110146MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Jan 23, 2024 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

65 S Main St
Ste A
Rockford, MI 49341

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": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1346708450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 LAWRENCE AVE",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481474",
            "telephone_number": "269-271-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "THERESA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "RUTGERS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.