Individual provider Active NPI

Kaytlin Ann Bieri

  • Clinical Social Worker
  • Holland, MI
National Provider Identifier
1609625110
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851112858 Issued in MI
Practice address
890 Washington Ave Ste 150
Holland, MI 49423-7702
Phone
(616) 952-9957
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851112858 MI
Clinical Social Worker 1041C0700X 6851112858 MI Primary

Addresses

Primary practice location

890 Washington Ave Ste 150
Holland, MI 49423-7702

Mailing address

890 Washington Ave Ste 150
Holland, MI 49423-7702
Phone (616) 952-9957

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
6851112858MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Psychological Services LLC CurrentSince May 19, 2024 Accepting new patients

Locations

890 Washington Ave
Ste 150
Holland, MI 49423
Phone (616) 952-9957

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, 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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1609625110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 WASHINGTON AVE STE 150",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237702",
            "telephone_number": "616-952-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 WASHINGTON AVE STE 150",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237702",
            "telephone_number": "616-952-9957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIERI",
        "first_name": "KAYTLIN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851112858",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851112858",
            "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 May 16, 2024; 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.