Individual provider Active NPI

Maurice Grondin, LMSW LMFT CAADC

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1609975622
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801012524 Issued in MI
Practice address
1500 E Beltline Ave SE
Ste 105
Grand Rapids, MI 49506-4361
Phone
(616) 322-0705
Fax
(616) 233-3229
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 6801012524 MI Primary
Marriage & Family Therapist 106H00000X 4101005798 MI

Addresses

Primary practice location

1500 E Beltline Ave SE
Ste 105
Grand Rapids, MI 49506-4361

Mailing address

1500 E Beltline Ave SE
Ste 105
Grand Rapids, MI 49506-4361
Phone (616) 322-0705

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801012524MIMDSocial Worker
4101005798MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BC Price Professional Services LLC PastSince Feb 1, 2009 Accepting new patients
Life Guidance Services Social Worker Past Accepting new patients

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1609975622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E BELTLINE AVE SE",
            "address_2": "STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064361",
            "telephone_number": "616-322-0705",
            "fax_number": "616-233-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E BELTLINE AVE SE",
            "address_2": "STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064361",
            "telephone_number": "616-322-0705",
            "fax_number": "616-233-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONDIN",
        "first_name": "MAURICE",
        "credential": "LMSW  LMFT CAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801012524",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.