Desiree Andersen
Individual provider Active NPI Clinical Social Worker · Grandville, MI
NPI 1487031258 · NPPES record last updated Aug 11, 2025
Key facts
- NPI
- 1487031258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801096051 (MI)
- Practice address
- 4120 Chicago Dr SW Ste 4
Grandville, MI 49418-1281 - Phone
- (616) 889-6602
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170626001276 | MI | Practitioner - Clinical Social Worker | 9436427903 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Rapids Integrative Therapy LLC | Clinical | Current |
Accepting new patients |
| Virtuwell Therapy, LLC | Past |
Accepting new patients |
Locations
4120 Chicago Dr SW
Ste 4
Grandville, MI 49418
Phone (616) 889-6602
4120 Chicago Dr SW
Ste 1
Grandville, MI 49418
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801096051 | ||
| Clinical Social Worker | 1041C0700X | 6801096051 | MI | Yes |
Addresses
Primary practice location
4120 Chicago Dr SW Ste 4
Grandville, MI 49418-1281
Mailing address
4120 Chicago Dr SW Ste 4
Grandville, MI 49418-1281
Other providers in Grandville, MI
- Alyssa Davidson, LLC
- Alyssa Davidson, LLC
- Alice Ambrose
- America'S Best Contacts & Eyeglasses
- Sharifa Amini
- Kirk Andriessen
- Gina Charlene Ang
- Cora Summer Anthony
- Kathryn Antor
- Apogee Therapy Center, LLC
All providers in Grandville, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.