NPIMap

Organization Active NPI

Grand Rapids Center for Psychotherapy PLLC

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
National Provider Identifier
1679899280
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
680103034469 Issued in MI
Legal business name
GRAND RAPIDS CENTER FOR PSYCHOTHERAPY PLLC
Practice address
4519 Cascade Rd SE
Suite 3
Grand Rapids, MI 49546-3666
Phone
(616) 949-6262
Fax
(616) 425-2003
NPI assigned
Apr 8, 2010
Last updated
Apr 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Authorized official

Name
Ms. Carolyn H Carino, LMSW ACSW SPADANPI 1417247107
Title
Owner/President
Phone
(616) 949-6262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 680103034469 MI Primary

Addresses

Primary practice location

4519 Cascade Rd SE
Suite 3
Grand Rapids, MI 49546-3666

Mailing address

4519 Cascade Rd SE
Suite 3
Grand Rapids, MI 49546-3666
Phone (616) 949-6262

Other identifiers 2

IdentifierTypeStateIssuer
881817049OtherNATIONAL ASSOCIATION OF SOCIAL WORKERS ACADEMY OF CERTIFIED SOCIAL WORKERS
6801034469OtherMISTATE OF MICHIGAN DEPARTMENT OF COMMUNITY HEALTH LICENSE

Other names 1

  • Carolyn H. Carino LMSW ACSW SPADA Other name

National Provider Directory

National Provider Directory

Locations

4519 Cascade Rd SE
Ste 3
Grand Rapids, MI 49546
Phone (616) 949-6262

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1679899280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 CASCADE RD SE",
            "address_2": "SUITE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463666",
            "telephone_number": "616-949-6262",
            "fax_number": "616-425-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 CASCADE RD SE",
            "address_2": "SUITE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463666",
            "telephone_number": "616-949-6262",
            "fax_number": "616-425-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RAPIDS CENTER FOR PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "CARINO",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "616-949-6262",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW ACSW SPADA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "680103034469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ASSOCIATION OF SOCIAL WORKERS ACADEMY OF CERTIFIED SOCIAL WORKERS",
            "identifier": "881817049",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN DEPARTMENT OF COMMUNITY HEALTH LICENSE",
            "identifier": "6801034469",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolyn H. Carino LMSW ACSW SPADA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.