Individual provider Active NPI

Rachel Marie Lettinga, MSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1558700484
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095393 Issued in MI
Practice address
385 Leonard St NE
Grand Rapids, MI 49503-1129
Phone
(616) 454-4777
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801095393 MI Primary

Addresses

Primary practice location

385 Leonard St NE
Grand Rapids, MI 49503-1129

Mailing address

385 Leonard St NE
Grand Rapids, MI 49503-1129
Phone (616) 454-4777

Other names 1

  • Rachel Marie Gale Former name

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
I20160912001601 MI Practitioner - Clinical Social Worker 8820384233 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Path Counseling Services, L.L.C. Clinical Current Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Mar 6, 2017 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Mar 6, 2017 Accepting new patients
Counseling Center of West Michigan, LLC CurrentSince Jun 1, 2020 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

3280 Beltline Ct NE
Ste 100
Grand Rapids, MI 49525
Phone (616) 258-0687

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

65 S Main St
Ste A
Rockford, MI 49341

3800 Lake Michigan Dr NW
Walker, MI 49534
Phone (616) 453-8225

Organizations & group practices 6

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1558700484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031129",
            "telephone_number": "616-454-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031129",
            "telephone_number": "616-454-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTINGA",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "GALE",
            "middle_name": "MARIE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.