Active NPI
Larissa Weld
- Clinical Social Worker
- Allegan, MI
National Provider Identifier
1770056095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801103102
- Practice address
- 3283 122ND Ave
Allegan, MI 49010-9511 - Phone
- (269) 673-6617
- NPI assigned
- Jan 9, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 6801103102 | MI | Primary |
Addresses
Primary practice location
3283 122ND Ave
Allegan, MI 49010-9511
Mailing address
115 E Maple St
Kalamazoo, MI 49001-2830
Phone (269) 568-5572
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 |
|---|---|---|---|
| 6801103102 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allegan County Community Mental Health | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Allegan, MI
- NPI 1801119466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1770056095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E MAPLE ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490012830",
"telephone_number": "269-568-5572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3283 122ND AVE",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490109511",
"telephone_number": "269-673-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELD",
"first_name": "LARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-09",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801103102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.