Individual provider Active NPI

Kimberly Ann Case, LMSW

  • Clinical Social Worker
  • Allegan, MI
National Provider Identifier
1558758102
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801115485 Issued in MI
Practice address
277 North St
Allegan, MI 49010-1138
Phone
(269) 673-5092
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801115485 MI Primary
Clinical Social Worker 1041C0700X 6851107824 MI

Addresses

Primary practice location

277 North St
Allegan, MI 49010-1138

Mailing address

3285 122ND Ave
Allegan, MI 49010-9511
Phone (269) 673-6617

Other identifiers 1

IdentifierTypeStateIssuer
6802088177MedicaidMI

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
I20221205002930 MI Practitioner - Clinical Social Worker 3375912884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

3124 N Wellness Dr
Suite 50
Holland, MI 49424-8121
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801115485MIMDClinical Social Worker
6851107824MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Jan 18, 2023 Accepting new patients
Jack a Dekkinga MD PC PastSince Jan 18, 2023 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

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

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

3124 N Wellness Dr
Ste 50
Holland, MI 49424
Phone (616) 263-1678

65 S Main St
Ste A
Rockford, MI 49341

Organizations & group practices 3

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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1558758102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 122ND AVE",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "269-673-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 NORTH ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101138",
            "telephone_number": "269-673-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2024-01-15",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115485",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851107824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6802088177",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

Verify at the official NPI Registry.