Individual provider Active NPI

Benjamin Gitler, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1700284130
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088730 Issued in MI
Practice address
800 Monroe Ave NW Ste 202
Grand Rapids, MI 49503-1448
Phone
(616) 239-2566
NPI assigned
Dec 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801088730 MI Primary

Addresses

Primary practice location

800 Monroe Ave NW Ste 202
Grand Rapids, MI 49503-1448

Mailing address

2177 Woodlark Dr
Holland, MI 49424-2800
Phone (616) 283-8619

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

State licenses

LicenseStateTypeSpecialty
6801088730MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1700284130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 WOODLARK DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242800",
            "telephone_number": "616-283-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MONROE AVE NW STE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031448",
            "telephone_number": "616-239-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITLER",
        "first_name": "BENJAMIN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-17",
        "last_updated": "2023-06-07",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088730",
            "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 Jun 7, 2023; 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.