Elizabeth Vanwoerkom, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

455049055 Issued in MI

Practice address

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Phone

(616) 336-3909

Fax

(616) 336-8830

NPI assigned

Jan 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Behavior Analysts of West Michigan, LLC

  • Community/Behavioral Health Agency
  • Walker, MI
  • NPI 1487035879
  NPD (past)

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1730652322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2787 Wilson Ave NW",
            "address_purpose": "LOCATION",
            "city": "Walker",
            "state": "MI",
            "postal_code": "495347510",
            "country_code": "US",
            "telephone_number": "616-915-2066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANWOERKOM",
        "first_name": "ELIZABETH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "455049055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487035879",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.network180.x@direct.mihin.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "790 Fuller Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495031918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler Vincent Vanvelsen, MD
• Lara Vanvolkinburg
• Kerrie Anne Vanweelden, LMSW
• Jeffrey Joseph Vanwingen, M.D.
• Robin Sandra Vanwingen, PA-C
• Jason Russell Vanwormer, MSW
• Kaitlin Vanwormer, MA LLC
• Austin Michael Vanwyk, MD
• Rachel Vanwylen, M.A.,CCC-SLP
• Jenifer Joy Vanwyngarden, LBSW, RN, DNP

• Behavior Analyst in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.