Individual provider Active NPI

Mary Elizabeth Demarest, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1366846693
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801060898 Issued in MI
Practice address
201 Monroe Ave NW
Suite 400
Grand Rapids, MI 49503-2212
Phone
(800) 600-4096
Fax
(800) 606-8839
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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 6801060898 MI Primary

Addresses

Primary practice location

201 Monroe Ave NW
Suite 400
Grand Rapids, MI 49503-2212

Mailing address

201 Monroe Ave NW
Suite 400
Grand Rapids, MI 49503-2212
Phone (800) 600-4096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 1, 2017 through Mar 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801060898MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1366846693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MONROE AVE NW",
            "address_2": "SUITE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032212",
            "telephone_number": "800-600-4096",
            "fax_number": "800-606-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MONROE AVE NW",
            "address_2": "SUITE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032212",
            "telephone_number": "800-600-4096",
            "fax_number": "800-606-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAREST",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801060898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.