Individual provider Active NPI

Timeco Bolden, LMSW

  • Case Manager/Care Coordinator
  • Lowell, MI
National Provider Identifier
1548539059
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
6801089093 Issued in MI
Practice address
11652 W Grand River Ave
Lowell, MI 49331-8465
Phone
(616) 897-5900
NPI assigned
Dec 29, 2011
Last updated
Dec 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 6801089093 MI Primary

Addresses

Primary practice location

11652 W Grand River Ave
Lowell, MI 49331-8465

Mailing address

11652 W Grand River Ave
Lowell, MI 49331-8465
Phone (616) 897-5900

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
I20160628000137 MI Practitioner - Clinical Social Worker 7113218868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encourage Counseling LLCGroup PAC ID 4688721913, 5 clinicians

Practice addresses (Care Compare)

607 Heritage CT
Suite a
Holland, MI 49423-5443
Phone (616) 396-6285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801089093MIMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Encourage Counseling LLC CurrentSince Jun 21, 2017 Accepting new patients

Locations

607 Heritage Ct
Holland, MI 49423
Phone (616) 396-3399

607 Heritage Ct
Ste A
Holland, MI 49423
Phone (616) 396-6285

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, 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": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1548539059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11652 W GRAND RIVER AVE",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318465",
            "telephone_number": "616-897-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11652 W GRAND RIVER AVE",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318465",
            "telephone_number": "616-897-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "TIMECO",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6801089093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MI

Sources for this page

Verify at the official NPI Registry.