Active NPI
Carrie Pebley, LMSW
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1417291436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801086032
- Practice address
- 781 36TH St SE
Grand Rapids, MI 49548-2319 - Phone
- (616) 248-5122
- Fax
- (616) 243-2302
- NPI assigned
- Nov 15, 2012
- Last updated
- Sep 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801086032 | MI | Primary |
Addresses
Primary practice location
781 36TH St SE
Grand Rapids, MI 49548-2319
Mailing address
PO Box 141
Grand Rapids, MI 49501-0141
Phone (616) 248-5122
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801086032 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1417291436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 141",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495010141",
"telephone_number": "616-248-5122",
"fax_number": "616-243-2302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "781 36TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495482319",
"telephone_number": "616-248-5122",
"fax_number": "616-243-2302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEBLEY",
"first_name": "CARRIE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801086032",
"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 Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.