Individual provider Active NPI

Melinda S Triemstra, LCSW

  • Social Worker
  • Dowagiac, MI
National Provider Identifier
1356448054
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801091057 Issued in MI
Practice address
520 Main St
Dowagiac, MI 49047-1762
Phone
(269) 783-3052
NPI assigned
Sep 17, 2006
Last updated
Nov 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801091057 MI Primary
Clinical Social Worker 1041C0700X LSW3080 TN

Addresses

Primary practice location

520 Main St
Dowagiac, MI 49047-1762

Mailing address

3410 Random Rd
Kalamazoo, MI 49004
Phone (269) 364-5302

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
I20130529000293 MI Practitioner - Clinical Social Worker 8325286677 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW3080TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Van Buren Community Mental Health Authority Clinical CurrentSince Sep 9, 2024 Accepting new patients
Beacon Dowagiac Inc CurrentSince Apr 22, 2013 Accepting new patients
Beacon Dowagiac Inc CurrentSince Apr 22, 2013 Accepting new patients
Lifeline Counseling Center PLLC Clinical Past Accepting new patients
Diversified Psychological Services LLC Social Worker PastSince Nov 1, 2025 Accepting new patients

Locations

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

520 Main St
Dowagiac, MI 49047
Phone (269) 390-0536

520 Main St
Ste A
Dowagiac, MI 49047
Phone (269) 783-3052

1717 Shaffer St
Ste 002
Kalamazoo, MI 49048

801 Hazen St
Ste C
Paw Paw, MI 49079
Phone (269) 657-5574

1007 Wells St
South Haven, MI 49090
Phone (269) 637-5297

Organizations & group practices 5

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1356448054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 RANDOM RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49004",
            "telephone_number": "269-364-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MAIN ST",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490471762",
            "telephone_number": "269-783-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIEMSTRA",
        "first_name": "MELINDA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801091057",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW3080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dowagiac, MI

Sources for this page

Verify at the official NPI Registry.