Individual provider Active NPI

Joseph Merrell III, ACSW

  • Clinical Social Worker
  • Grand Haven, MI
National Provider Identifier
1710152855
Registry record updated Aug 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801016149 Issued in MI
Practice address
41 Washington Ave
Suite 368
Grand Haven, MI 49417-1390
Phone
(616) 844-7003
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2009

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 6801016149 MI Primary

Addresses

Primary practice location

41 Washington Ave
Suite 368
Grand Haven, MI 49417-1390

Mailing address

PO Box 841
Grand Haven, MI 49417-0841
Phone (616) 844-7003

Other identifiers 1

IdentifierTypeStateIssuer
089861-10OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090120000375 MI Practitioner - Clinical Social Worker 2769545698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

41 Washington Ave
Suite 304
Grand Haven, MI 49417-1481
Phone (616) 844-7003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801016149MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Merrell Recovery Associates PLLC CurrentSince Oct 1, 2016 Accepting new patients

Locations

41 Washington Ave
Ste 368
Grand Haven, MI 49417
Phone (616) 638-8830

41 Washington Ave
Ste 304
Grand Haven, MI 49417
Phone (248) 977-2747

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1710152855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494170841",
            "telephone_number": "616-844-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE",
            "address_2": "SUITE 368",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171390",
            "telephone_number": "616-844-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801016149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "089861-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.