Active NPI
Maria Vandenboom, LMSW
- Clinical Social Worker
- Holt, MI
National Provider Identifier
1760157549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801060160
- Practice address
- 5896 Harper Rd
Holt, MI 48842-8617 - Phone
- (517) 281-8558
- NPI assigned
- Aug 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801060160 | MI | Primary |
Addresses
Primary practice location
5896 Harper Rd
Holt, MI 48842-8617
Mailing address
5896 Harper Rd
Holt, MI 48842-8617
Phone (517) 281-8558
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Holt |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801060160 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1760157549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5896 HARPER RD",
"city": "HOLT",
"state": "MI",
"postal_code": "488428617",
"telephone_number": "517-281-8558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5896 HARPER RD",
"city": "HOLT",
"state": "MI",
"postal_code": "488428617",
"telephone_number": "517-281-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBOOM",
"first_name": "MARIA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-12",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801060160",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Holt",
"affiliation": "N",
"address_1": "5896 Harper Rd",
"city": "Holt",
"state": "MI",
"country_code": "US",
"postal_code": "488428617",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.