Individual provider Active NPI

Chantelle Marie Robbe, LMSW

  • Clinical Social Worker
  • Portage, MI
National Provider Identifier
1356361521
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801082669 Issued in MI
Practice address
1651 W Centre Ave Ste 209
Portage, MI 49024-5321
Phone
(269) 366-0650
NPI assigned
Jul 20, 2006
Last updated
Mar 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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 6801082669 MI Primary

Addresses

Primary practice location

1651 W Centre Ave Ste 209
Portage, MI 49024-5321

Mailing address

6322 Trotwood St
Portage, MI 49024-3251
Phone (616) 402-0364

Other identifiers 1

IdentifierTypeStateIssuer
1356361521OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Chantelle Marie Brochu 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
I20180109002409 MI Practitioner - Clinical Social Worker 4587923040 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801082669MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Nov 18, 2021 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Nov 18, 2021 Accepting new patients
Greenhouse and Associates Inc. Past Accepting new patients
Hac Hearing Aid Centers of America Inc Past Accepting new patients

Locations

1530 Nichols Rd
Kalamazoo, MI 49006
Phone (269) 343-6700

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1356361521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 TROTWOOD ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243251",
            "telephone_number": "616-402-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 W CENTRE AVE STE 209",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245321",
            "telephone_number": "269-366-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBBE",
        "first_name": "CHANTELLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801082669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1356361521",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANTELLE",
            "last_name": "BROCHU",
            "middle_name": "MARIE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.