Active NPI
Kelsey Leonard, LMSW
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1639451644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801093523
- Practice address
- 1101 Ball Ave NE
Grand Rapids, MI 49505-5904 - Phone
- (616) 456-6571
- NPI assigned
- Sep 15, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801093523 | MI | Primary |
| Social Worker | 104100000X | 6801093523 | MI |
Addresses
Primary practice location
1101 Ball Ave NE
Grand Rapids, MI 49505-5904
Mailing address
500 Fulton St E
Apt 289
Grand Rapids, MI 49503-5917
Other practice location 1
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 336-3909
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcerecord.network180.x@direct.mihin.net | Direct |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arbor Circle Corporation | Past | Accepting new patients | |
| Arbor Circle Corporation | Clinical | 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.
-
- Clinical Social Worker
- Grand Rapids, MI
- NPI 1174601512
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1740585330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1639451644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 FULTON ST E",
"address_2": "APT 289",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 BALL AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495055904",
"telephone_number": "616-456-6571"
}
],
"practiceLocations": [
{
"address_1": "790 Fuller Ave NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495031918",
"country_code": "US",
"telephone_number": "616-336-3909",
"fax_number": "616-336-8830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEONARD",
"first_name": "KELSEY",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-15",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801093523",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801093523",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pcerecord.network180.x@direct.mihin.net",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "790 Fuller Ave NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495031918",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 18, 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.