Active NPI
Carol Vandelin, M.S.W.
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1700811650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801001317
- Practice address
- 3000 Monroe Ave NE
Grand Rapids, MI 49505-3397 - Phone
- (616) 364-5295
- Fax
- (616) 365-3804
- NPI assigned
- Jul 11, 2006
- 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 | 6801001317 | MI | Primary |
Addresses
Primary practice location
3000 Monroe Ave NE
Grand Rapids, MI 49505-3397
Mailing address
3000 Monroe Ave NE
Grand Rapids, MI 49505-3397
Phone (616) 364-5295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CV001317 | Other | MI | BCBS OF MICHIGAN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801001317 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700811650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 MONROE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495053397",
"telephone_number": "616-364-5295",
"fax_number": "616-365-3804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 MONROE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495053397",
"telephone_number": "616-364-5295",
"fax_number": "616-365-3804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDELIN",
"first_name": "CAROL",
"credential": "M.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801001317",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MICHIGAN",
"identifier": "CV001317",
"state": "MI"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.