Kirstin Davis, LMSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801099579 Issued in MI

Practice address

300 68TH St SE
Grand Rapids, MI 49548-6927

Phone

(616) 455-5000

NPI assigned

Jun 29, 2016

Last updated

Apr 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Memorial Hospital

  dba Memorial Medical Associates

  • General Practice Physician
  • Owosso, MI
  • NPI 1235160532
  NPD
• Memorial Hospital

  dba Memorial Medical Associates

  • General Practice Physician
  • Owosso, MI
  • NPI 1316008006
  NPD
• Memorial Hospital

  dba Memorial Medical Associates

  • Anesthesiology Physician
  • Owosso, MI
  • NPI 1659527737
  NPD
• Pine Rest Christian Mental Health Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1386015683
  NPD
• Pine Rest Christian Mental Health Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1922019157
  NPD
• Berrien Mental Health Authority

  dba NorthStar Center

  • Psychiatry Physician
  • Saint Joseph, MI
  • NPI 1508801465
  NPD (past)

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1639520836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KIRSTIN",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Nichole Davis, R.D.
• Jocelyn R Davis, D.D.S.
• Joshua Luke Davis, NP
• Katlin Davis
• Khalidha Davis
• Lance Davis
• Malcolm Davis, MD
• Mark Collins Davis, OD
• Martha Ann Davis, LPC
• Mary Gadbaw Davis, CNM

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.