Individual provider Active NPI

Shawna Johnson, BSW

  • Social Worker
  • Wyoming, MI
National Provider Identifier
1487113346
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3353 Lousma Dr SE
Wyoming, MI 49548-2251
Phone
(616) 241-6258
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X B450765564075 MI
Social Worker 104100000X MI Primary

Addresses

Primary practice location

3353 Lousma Dr SE
Wyoming, MI 49548-2251

Mailing address

3353 Lousma Dr SE
Wyoming, MI 49548-2251
Phone (616) 241-6258

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
I20230418002340 MI Practitioner - Clinical Social Worker 5294100525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

710 Kenmoor Ave SE
Suite 100
Grand Rapids, MI 49546-2379
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B450765564075MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Mar 3, 2023 Accepting new patients

Locations

710 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 425-1276

524 E Milham Ave
Ste B
Portage, MI 49002
Phone (269) 264-4920

7333 Triangle Dr
Sterling Hts, MI 48314
Phone (248) 686-3347

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 1

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1487113346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 LOUSMA DR SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482251",
            "telephone_number": "616-241-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 LOUSMA DR SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482251",
            "telephone_number": "616-241-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAWNA",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "B450765564075",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.