Active NPI
Jessica Warner
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1649673591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801097102
- Practice address
- 100 Cherry St SE
Grand Rapids, MI 49503-4526 - Phone
- (616) 965-8200
- NPI assigned
- Oct 7, 2014
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801097102 | MI | Primary |
Addresses
Primary practice location
100 Cherry St SE
Grand Rapids, MI 49503-4526
Mailing address
5250 Northland Dr NE
Ste a
Grand Rapids, MI 49525-1096
Phone (616) 361-5000
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801097102 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent County CMH Authority | Current | Accepting new patients | |
| Kent County CMH Authority | Current | Accepting new patients | |
| Cherry Street Services Inc | Clinical | Past | Accepting new patients |
| Virtuwell Therapy, LLC | Past | Accepting new patients |
Locations
260 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 459-1267
790 Fuller Ave NE
Grand Rapids, MI 49503
Phone (616) 336-3765
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1588935068
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1194617811
-
- Federally Qualified Health Center (FQHC)
- Cedar Springs, MI
- NPI 1184015539
Clinical
-
- Mental Health Counselor
- Grand Rapids, MI
- NPI 1871356212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1649673591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5250 NORTHLAND DR NE",
"address_2": "STE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495251096",
"telephone_number": "616-361-5000",
"fax_number": "616-361-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CHERRY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034526",
"telephone_number": "616-965-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARNER",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-07",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801097102",
"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 Aug 26, 2020; 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.