Individual provider Active NPI

Kelly Jo Crabb, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1407389604
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094851 Issued in MI
Practice address
4829 E Beltline Ave NE Ste 100
Grand Rapids, MI 49525
Phone
(616) 364-3301
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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 6801094851 MI Primary

Addresses

Primary practice location

4829 E Beltline Ave NE Ste 100
Grand Rapids, MI 49525

Mailing address

4829 E Beltline Ave NE Ste 100
Grand Rapids, MI 49525-9349
Phone (616) 364-3301

Other practice location 1

1675 Baldwin St
Jenison, MI 49428-8912
Phone (616) 426-9034 ext. 501

Other practice location 2

1675 Baldwin St
Jenison, MI 49428-8912
Phone (616) 426-9034 ext. 501

Other names 1

  • Kelly Jo McCaleb Former name

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
I20180209001192 MI Practitioner - Clinical Social Worker 6204196371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

4250 Chicago Dr SW
Suite B
Grandville, MI 49418-1506
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Oct 3, 2024 Accepting new patients
KJ Counseling LLC Current Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

4829 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49525
Phone (616) 364-3301

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

4250 Chicago Dr SW
#B
Grandville, MI 49418
Phone (269) 419-2392

65 S Main St
Ste A
Rockford, MI 49341

3800 Lake Michigan Dr NW
Ste 103
Walker, MI 49534
Phone (616) 499-7209

Organizations & group practices 3

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1407389604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259349",
            "telephone_number": "616-364-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-364-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Baldwin St",
            "address_purpose": "LOCATION",
            "city": "Jenison",
            "state": "MI",
            "postal_code": "494288912",
            "country_code": "US",
            "telephone_number": "616-426-9034 x501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 Baldwin St",
            "address_purpose": "LOCATION",
            "city": "Jenison",
            "state": "MI",
            "postal_code": "494288912",
            "country_code": "US",
            "telephone_number": "616-426-9034 x501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRABB",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MCCALEB",
            "middle_name": "JO",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.