Individual provider Active NPI

Madelyn Van Dyke

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1376422261
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1111 40TH St SE
Grand Rapids, MI 49508-6084
Phone
(616) 258-6389
Fax
(616) 258-6389
NPI assigned
Aug 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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 Primary

Addresses

Primary practice location

1111 40TH St SE
Grand Rapids, MI 49508-6084

Mailing address

1111 40TH St SE
Grand Rapids, MI 49508-6084
Phone (616) 258-6389

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Community Services CurrentSince Sep 3, 2025 Accepting new patients
Spectrum Community Services CurrentSince Sep 3, 2025 Accepting new patients

Locations

1111 40th St SE
Wyoming, MI 49508
Phone (616) 516-7131

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": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1376422261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 40TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495086084",
            "telephone_number": "616-258-6389",
            "fax_number": "616-258-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 40TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495086084",
            "telephone_number": "616-258-6389",
            "fax_number": "616-258-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "MADELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.