Active NPI
Kendra Avila
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1679390041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 5060 Cascade Rd SE
Grand Rapids, MI 49546-3808 - Phone
- (423) 314-9584
- NPI assigned
- Sep 25, 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
5060 Cascade Rd SE
Grand Rapids, MI 49546-3808
Mailing address
5060 Cascade Rd SE
Grand Rapids, MI 49546-3808
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1679390041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5060 CASCADE RD SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495463808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5060 CASCADE RD SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495463808",
"telephone_number": "423-314-9584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "KENDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"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 Sep 25, 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.