Individual provider Active NPI

Deborah Kennedy-Kuiper, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1740707272
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097728 Issued in MI
Practice address
1971 E Beltline Ave NE Ste 204
Grand Rapids, MI 49525-7064
Phone
(800) 600-4096
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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 6801097728 MI Primary

Addresses

Primary practice location

1971 E Beltline Ave NE Ste 204
Grand Rapids, MI 49525-7064

Mailing address

201 Monroe Ave NW Ste 300
Grand Rapids, MI 49503-2212
Phone (616) 328-6600

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
6801097728MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
139 Education, LLC. Past Accepting new patients

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1740707272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MONROE AVE NW STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032212",
            "telephone_number": "616-328-6600",
            "fax_number": "866-606-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 E BELTLINE AVE NE STE 204",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257064",
            "telephone_number": "800-600-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY-KUIPER",
        "first_name": "DEBORAH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097728",
            "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 Aug 25, 2017; 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.