Criselda Bazan, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801079859 Issued in MI

Practice address

238 Hoover Blvd Ste 10
Holland, MI 49423-3755

Phone

(616) 591-9400

Fax

(616) 591-9060

NPI assigned

Jun 1, 2006

Last updated

May 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Grand Rapids Therapy Group Inc

  dba GR Therapy Group

  • Psychologist
  • Grand Rapids, MI
  • NPI 1295211076
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1487691358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 HOOVER BLVD STE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233755",
            "telephone_number": "616-591-9400",
            "fax_number": "616-591-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 HOOVER BLVD STE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233755",
            "telephone_number": "616-591-9400",
            "fax_number": "616-591-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "CRISELDA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801079859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Baumann, LPC
• Angela Baumgardner, RDH
• Jill Bawks, LMSW
• Wendy Baylor
• Debra Bayus, NP-C
• Julie Renee Bazuin, LMSW, CAADC
• Beach Counseling, LLC
• Skyla Christine Beaty
• Jeffrey Beauregard
• Joseph Andrew Bechard, MSW EDS LLP

• Clinical Social Worker in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.