Individual provider Active NPI

Elizza Brittany Lejeune, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1598157034
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096524 Issued in MI
Practice address
2118 3 Mile Rd NW
Grand Rapids, MI 49544
Phone
(616) 222-3720
Fax
(616) 222-3724
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801096524 MI
Social Worker 104100000X 12527 LA
Clinical Social Worker 1041C0700X 6801096524 MI Primary

Addresses

Primary practice location

2118 3 Mile Rd NW
Grand Rapids, MI 49544

Mailing address

2118 3 Mile Rd NW
Grand Rapids, MI 49544-1425
Phone (616) 222-3720

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
I20180322000170 MI Practitioner - Clinical Social Worker 3476815903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Tulane University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2118 3 Mile Rd NW
Grand Rapids, MI 49544-1425
Phone (616) 222-3720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12527LAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Mar 1, 2018 Accepting new patients
Community Mental Health for Central Michigan Clinical CurrentSince Apr 20, 2020 Accepting new patients
Community Mental Health for Central Michigan Clinical CurrentSince Apr 20, 2020 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Mar 1, 2018 Accepting new patients

Locations

655 E Cedar Ave
Gladwin, MI 48624
Phone (989) 426-9295

3225 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 364-1500

301 S Crapo St
Ste 1
Mount Pleasant, MI 48858

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

2118 3 Mile Rd NW
Walker, MI 49544
Phone (616) 222-3720

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 4

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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1598157034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 3 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441425",
            "telephone_number": "616-222-3720",
            "fax_number": "616-222-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 3 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49544",
            "telephone_number": "616-222-3720",
            "fax_number": "616-222-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEJEUNE",
        "first_name": "ELIZZA",
        "middle_name": "BRITTANY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801096524",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "12527",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.