Individual provider Active NPI

Meghan Elizabeth Southwell, LMSW

  • Social Worker
  • Grand Haven, MI
National Provider Identifier
1750917969
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801106666 Issued in MI
Practice address
1703 S Despelder St
Grand Haven, MI 49417-2649
Phone
(616) 402-3433
NPI assigned
Mar 19, 2020
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801106666 MI Primary

Addresses

Primary practice location

1703 S Despelder St
Grand Haven, MI 49417-2649

Mailing address

14758 Timber Lake CT
Spring Lake, MI 49456-9081

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.counselingcenterwm.org

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801106666MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meghan Southwell LLC Social Worker CurrentSince Nov 1, 2020 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

16175 Robbins Rd
Ste 2
Grand Haven, MI 49417
Phone (616) 920-1335

1703 S Despelder St
Grand Haven, MI 49417
Phone (616) 402-3433

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1750917969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14758 TIMBER LAKE CT",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S DESPELDER ST",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172649",
            "telephone_number": "616-402-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWELL",
        "first_name": "MEGHAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801106666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.counselingcenterwm.org",
            "affiliation": "N",
            "endpointDescription": "website contact information",
            "address_1": "Counseling Center of West Michigan",
            "address_2": "360 East Beltline Ave NE Suite 100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.