Active NPI
Nicole Ann Sutton, LLMSW
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1639991789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6851117799
- Practice address
- 2566 Woodmeadow Dr SE
Grand Rapids, MI 49546-8031 - Phone
- (616) 719-0194
- NPI assigned
- Oct 29, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6851117799 | MI | Primary |
Addresses
Primary practice location
2566 Woodmeadow Dr SE
Grand Rapids, MI 49546-8031
Mailing address
1021 Walker Ave NW Apt 2
Grand Rapids, MI 49504-4354
Phone (616) 990-0978
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6851117799 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1639991789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 WALKER AVE NW APT 2",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495044354",
"telephone_number": "616-990-0978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2566 WOODMEADOW DR SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468031",
"telephone_number": "616-719-0194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "NICOLE",
"middle_name": "ANN",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-29",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6851117799",
"primary": true
}
],
"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 Oct 29, 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.