Active NPI
Susan Conrad, MSW
- Social Worker
- Holland, MI
National Provider Identifier
1609110873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801066773
- Practice address
- 412 Century LN
Holland, MI 49423-4285 - Phone
- (616) 396-2301
- Fax
- (616) 396-8070
- NPI assigned
- Nov 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801066773 | MI | Primary |
Addresses
Primary practice location
412 Century LN
Holland, MI 49423-4285
Mailing address
412 Century LN
Holland, MI 49423-4285
Phone (616) 396-2301
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801066773 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1609110873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 CENTURY LN",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494234285",
"telephone_number": "616-396-2301",
"fax_number": "616-396-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 CENTURY LN",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494234285",
"telephone_number": "616-396-2301",
"fax_number": "616-396-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "SUSAN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-12",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801066773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.