Kimberly B Lavender, LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

KIMBERLY B LAVENDER, LLC

Practice address

309 1/2 S Lafayette St Ste 202
Greenville, MI 48838-1967

Phone

(616) 835-9292

NPI assigned

Nov 21, 2014

Last updated

Aug 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Beth Houpt

Title

Credentialing

Phone

(517) 676-9788

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tanya Douglas

  • Clinical Social Worker
  • Stanton, MI
  • NPI 1285183053
  Medicare reassignment Care Compare group NPD
• Amanda Janeen Fisher, LMSW

  • Social Worker
  • Greenville, MI
  • NPI 1063098564
  Medicare reassignment Care Compare group NPD
• Ada M Brosier, LMSW

  • Social Worker
  • Greenville, MI
  • NPI 1386901163
  Medicare reassignment NPD
• Carmon Therese Ferman, LMSW

  • Social Worker
  • Greenville, MI
  • NPI 1215483102
  Medicare reassignment NPD
• Kimberly Belle Lavender, LMSW

  • Social Worker
  • Greenville, MI
  • NPI 1285985358
  Medicare reassignment NPD

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1548667397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 1/2 S LAFAYETTE ST STE 202",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488381967",
            "telephone_number": "616-835-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY B LAVENDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9788"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093841",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSE",
            "identifier": "6801093841",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David I Kay, MD
• Tiffany Kelley, PHARMD
• James Howard Kelly, RPH
• Kevin T Oconnor DO PC
• Kimberlee J Odonald PT PC
• Jenny E Kipp, DNP
• Tammy Kay Kirby, ARNP-C
• Rachel Kloosterman
• Catherine Anne Knisley, RPH
• Sara Lyn Koenes, PA-C

• Social Worker in Greenville, MI
• Providers in Greenville, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.