Individual provider Active NPI

Michelle Frances Davis-Vanarnam, LLMSW

  • Mental Health Counselor
  • Stanton, MI
National Provider Identifier
1407909765
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801085547 Issued in MI
Practice address
611 N State St
Stanton, MI 48888-9702
Phone
(989) 831-7520
Fax
(989) 831-7578
NPI assigned
Jan 19, 2007
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801085547 MI Primary

Addresses

Primary practice location

611 N State St
Stanton, MI 48888-9702

Mailing address

3292 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 365-8920

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
I20080808000807 MI Practitioner - Clinical Social Worker 0648344630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801085547MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Resources and Institute for Neuropsychological Services CurrentSince Oct 9, 2019 Accepting new patients
Behavioral Resources and Institute for Neuropsychological Services CurrentSince Oct 9, 2019 Accepting new patients

Locations

3292 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 365-8920

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1407909765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3292 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-365-8920",
            "fax_number": "616-365-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N STATE ST",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889702",
            "telephone_number": "989-831-7520",
            "fax_number": "989-831-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-VANARNAM",
        "first_name": "MICHELLE",
        "middle_name": "FRANCES",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801085547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanton, MI

Sources for this page

Verify at the official NPI Registry.