Individual provider Active NPI

Molly Henson-Boone, LMSW

  • Clinical Social Worker
  • Holland, MI
National Provider Identifier
1588064372
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
607 Heritage CT
Holland, MI 49423-5481
Phone
(616) 396-6285
Fax
(616) 396-6172
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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 Primary

Addresses

Primary practice location

607 Heritage CT
Holland, MI 49423-5481

Mailing address

607 Heritage CT
Holland, MI 49423-5481
Phone (616) 396-6285

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
I20151104003059 MI Practitioner - Clinical Social Worker 2860702750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trio Wellspace, LLCGroup PAC ID 5092197699, 4 clinicians

Practice addresses (Care Compare)

486 Century LN
Holland, MI 49423-4295
Phone (616) 298-2731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trio Wellspace, LLC Clinical CurrentSince Mar 21, 2022 Accepting new patients

Locations

486 Century Ln
Holland, MI 49423
Phone (616) 298-2731

Organizations & group practices 2

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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1588064372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 HERITAGE CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235481",
            "telephone_number": "616-396-6285",
            "fax_number": "616-396-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 HERITAGE CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235481",
            "telephone_number": "616-396-6285",
            "fax_number": "616-396-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON-BOONE",
        "first_name": "MOLLY",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.