Board of Education Kent County

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

BOARD OF EDUCATION KENT COUNTY

Practice address

1331 Franklin St SE
Grand Rapids, MI 49506-2634

Phone

(616) 819-4806

NPI assigned

Nov 4, 2020

Last updated

Nov 4, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Videan

Title

Credentialing Coordinator

Phone

(800) 968-6866

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1407457633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 FRANKLIN ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 FRANKLIN ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062634",
            "telephone_number": "616-819-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF EDUCATION KENT COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "VIDEAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "800-968-6866"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Blury, MSW, LMSW, TF-CBT
• Michelle Lee Blystone, OTR/L
• Claire Elizabeth Blystra
• BMSC Mi LLC
• Michelle Lynn Boahbedason
• Kyle Boase, LPC
• Georgina Boateng, DO
• Clare A Bobb
• Delorrian Bobo
• Marisela Bobo, ETS, GCDF

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.