Individual provider Active NPI

Donique Kosters, LLMSW

  • Social Worker
  • Wyoming, MI
National Provider Identifier
1609267848
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801095994 Issued in MI
Practice address
3353 Lousma Dr SE
Wyoming, MI 49548-2251
Phone
(616) 241-6258
NPI assigned
Feb 10, 2015
Last updated
Feb 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801095994 MI Primary

Addresses

Primary practice location

3353 Lousma Dr SE
Wyoming, MI 49548-2251

Mailing address

3353 Lousma Dr SE
Wyoming, MI 49548-2251
Phone (616) 241-6258

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
I20150813011154 MI Practitioner - Clinical Social Worker 7214242692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1111 40TH St SE
Grand Rapids, MI 49508-6084
Phone (616) 241-6258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Community Services CurrentSince Feb 25, 2024 Accepting new patients

Locations

28303 Joy Rd
Westland, MI 48185
Phone (734) 458-8729

1111 40th St SE
Wyoming, MI 49508
Phone (616) 516-7131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1609267848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 LOUSMA DR SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482251",
            "telephone_number": "616-241-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 LOUSMA DR SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482251",
            "telephone_number": "616-241-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTERS",
        "first_name": "DONIQUE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801095994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.