Individual provider Active NPI

Joel S. Wilkinson, LLMSW

  • Social Worker
  • Grand Haven, MI
National Provider Identifier
1356693618
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094875 Issued in MI
Practice address
17000 Robbins Rd
Grand Haven, MI 49417-2788
Phone
(616) 396-0623
NPI assigned
Oct 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801094875 MI Primary

Addresses

Primary practice location

17000 Robbins Rd
Grand Haven, MI 49417-2788

Mailing address

17000 Robbins Rd
Grand Haven, MI 49417-2788
Phone (616) 396-0623

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
I20170817000159 MI Practitioner - Clinical Social Worker 3274805809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope and Wholeness Psychology Center LLCGroup PAC ID 6901175082, 18 clinicians

Practice addresses (Care Compare)

503 Century LN
Suite 2
Holland, MI 49423-4318
Phone (616) 795-0298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094875MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope & Wholeness Psychology Center, LLC CurrentSince Apr 1, 2021 Accepting new patients
Bethany Christian Services Inc. Past Accepting new patients

Locations

503 Century Ln
Ste 2
Holland, MI 49423
Phone (616) 295-8284

1877 Georgetown Center Dr
Jenison, MI 49428
Phone (616) 287-4330

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1356693618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 ROBBINS RD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172788",
            "telephone_number": "616-396-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 ROBBINS RD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172788",
            "telephone_number": "616-396-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "JOEL",
        "middle_name": "S.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.