Kathy A Carruthers, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801094220 Issued in MI

Practice address

1675 84TH St SE
Caledonia, MI 49316-7939

Phone

(616) 238-0159

NPI assigned

Jun 11, 2012

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kathy A Tillottson Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Carruthers Therapy LLC

  • Social Worker
  • Caledonia, MI
  • NPI 1083210843
  Medicare reassignment NPD Authorized official
• Pine Rest Christian Mental Health Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1922019157
  Medicare reassignment NPD

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1720340367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 ROYAL OAK ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495093562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 84TH ST SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167939",
            "telephone_number": "616-238-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTHERS",
        "first_name": "KATHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "TILLOTTSON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caledonia Vision Center, PLC (MKG Vision)
• Careatc
• Careatc - Caledonia
• Cortney Carlisle
• Carruthers Therapy LLC
• Laura Mechele Casey-Bir, IBCLC
• Patricia Brunck Cassell, LMSW
• Sarah Anne Chamberlain, PHARMD
• Chapp Chiropractic, P.L.L.C.
• James Anthony Chapp, D.C.

• Social Worker in Caledonia, MI
• Providers in Caledonia, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.