Cortney Rae Duffner, LMSW – Clinical Social Worker

Key facts

NPI: 1356739403
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 6801088062 (MI)
Practice address: 11630 Fulton St E
Lowell, MI 49331-9426
Phone: (616) 481-3784
NPI assigned: Dec 23, 2014
Sex: Female
Sole proprietor: No

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.

Childhood Behavior Consulting Services Clinical Social Worker · Grand Rapids, MI · NPI 1700359478

NPD Authorized official CLINICAL
Martino Health & Wellness Mental Health Counselor · Lowell, MI · NPI 1982416111

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
6801088062	MI	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Childhood Behavior Consulting Services	Clinical	Current	Accepting new patients
Martino Health & Wellness		Past since Jan 26, 2025	Accepting new patients

Locations

4829 E Beltline Ave NE
Ste 303
Grand Rapids, MI 49525
Phone (616) 202-2762

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	6801088062	MI	Yes

Addresses

Primary practice location

11630 Fulton St E
Lowell, MI 49331-9426

Mailing address

5580 Highbury Dr SE
Ada, MI 49301-7738
Phone (616) 443-7009

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 23, 2014.

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1356739403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 HIGHBURY DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493017738",
            "telephone_number": "616-443-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11630 FULTON ST E",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493319426",
            "telephone_number": "616-481-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFNER",
        "first_name": "CORTNEY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MI

All providers in Lowell, MI · Clinical Social Worker in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.