NPIMap

Organization Active NPI

Grand Rapids Therapy PLLC

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1699146134
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801088826 Issued in MI
Legal business name
GRAND RAPIDS THERAPY PLLC
Practice address
3501 Lake Eastbrook Blvd SE
Ste 280
Grand Rapids, MI 49546-5938
Phone
(517) 202-9123
Fax
(517) 323-9531
NPI assigned
Oct 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Authorized official

Name
Cathy Gallegos
Title
Manager Billing
Phone
(517) 483-2461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6801088826 MI Primary

Addresses

Primary practice location

3501 Lake Eastbrook Blvd SE
Ste 280
Grand Rapids, MI 49546-5938

Mailing address

3501 Lake Eastbrook Blvd SE
Ste 280
Grand Rapids, MI 49546-5938
Phone (517) 202-9123

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1699146134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "STE 280",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465938",
            "telephone_number": "517-202-9123",
            "fax_number": "517-323-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "STE 280",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465938",
            "telephone_number": "517-202-9123",
            "fax_number": "517-323-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RAPIDS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "MANAGER BILLING",
        "authorized_official_telephone_number": "517-483-2461"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801088826",
            "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 9, 2015; 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.