Individual provider Active NPI

Nicole Steffen, LMSW

  • Clinical Social Worker
  • Jenison, MI
National Provider Identifier
1639560204
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801103907 Issued in MI
Practice address
7782 20TH Ave
Jenison, MI 49428
Phone
(616) 685-8700
Fax
(616) 457-5567
NPI assigned
Feb 18, 2015
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801103907 MI Primary

Addresses

Primary practice location

7782 20TH Ave
Jenison, MI 49428

Mailing address

PO Box 776974
Chicago, IL 60677-6974
Phone (231) 672-2119

Other practice location 1

4255 Kalamazoo Ave SE
Grand Rapids, MI 49508-3638
Phone (616) 455-0960

Other names 1

  • Nicole Hanson Former name

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
I20190325000148 MI Practitioner - Clinical Social Worker 6608116983 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Mar 11, 2019 Accepting new patients
Mercy Physician Network CurrentSince May 1, 2022 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Mar 11, 2019 Accepting new patients
Mercy Physician Network CurrentSince May 1, 2022 Accepting new patients
Mercy Health Partners - Physician Specialist CurrentSince May 1, 2022 Accepting new patients
Thresholds Inc PastSince Jul 26, 2010 Accepting new patients
Kent County CMH Authority Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

7782 20th Ave
Jenison, MI 49428
Phone (616) 685-8700

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

1150 E Sherman Blvd
Ste 1175
Norton Shores, MI 49444
Phone (231) 672-6740

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1639560204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776974",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776974",
            "telephone_number": "231-672-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7782 20TH AVE",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "49428",
            "telephone_number": "616-685-8700",
            "fax_number": "616-457-5567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4255 Kalamazoo Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495083638",
            "country_code": "US",
            "telephone_number": "616-455-0960",
            "fax_number": "616-455-7324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEFFEN",
        "first_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HANSON",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jenison, MI

Sources for this page

Verify at the official NPI Registry.