Holly Lynn Jones, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801118115 Issued in MI

Practice address

4370 Chicago Dr SW # 515
Grandville, MI 49418-1694

Phone

(616) 287-2283

Fax

(616) 585-0148

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Holly Lynn Shibler Former name

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

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.

• Hackley Community Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1427787621
  NPD (past)
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1669990834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 515",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "616-287-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 515",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "616-287-2283",
            "fax_number": "616-585-0148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Northland Dr NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "MI",
            "postal_code": "493417246",
            "country_code": "US",
            "telephone_number": "616-805-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SOCIAL WORK",
            "identifier": "6801101297",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "SHIBLER",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "LLMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlyn Johnson, RN
• Tommie Earl Johnson, LLMSW
• Martha Johnston, PTA
• Chelsie Jones, LPC
• Elmira Jones
• Samantha Jordan, RBT
• Joseph Budnick
• Mallory Kathryn Joseph, MD
• Joshua Smith Dental PLLC
• Joyful Life Counseling GR

• Clinical Social Worker in Grandville, MI
• Providers in Grandville, 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 May 29, 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.