Individual provider Active NPI

Molly Kay Dehoog, LMSW, LCSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1568895340
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801113894 Issued in MI
Practice address
826 Parchment Dr SE Ste 100
Grand Rapids, MI 49546-2307
Phone
(616) 366-4226
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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 6801113894 MI Primary

Addresses

Primary practice location

826 Parchment Dr SE Ste 100
Grand Rapids, MI 49546-2307

Mailing address

326 Eastmoor Ave SE
Grand Rapids, MI 49546-2227
Phone (616) 581-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801113894MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mantra LLC Clinical CurrentSince Feb 2, 2025 Accepting new patients

Locations

826 Parchment Dr SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 366-4226

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1568895340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 EASTMOOR AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462227",
            "telephone_number": "616-581-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 PARCHMENT DR SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462307",
            "telephone_number": "616-366-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHOOG",
        "first_name": "MOLLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.