Individual provider Active NPI

Kassidy Barnett, LMSW

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1780064121
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801097966 Issued in MI
Practice address
1003 Parchment Dr SE
Grand Rapids, MI 49546-3664
Phone
(169) 577-7006
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 6801097966 MI Primary

Addresses

Primary practice location

1003 Parchment Dr SE
Grand Rapids, MI 49546-3664

Mailing address

2905 Wilson Ave SW
Grandville, MI 49418-1295
Phone (616) 320-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190613002074 MI Practitioner - Clinical Social Worker 3779816368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Eating Disorder SpecialistsGroup PAC ID 3577931930, 4 clinicians

Practice addresses (Care Compare)

2905 Wilson Ave SW
Suite 252
Grandville, MI 49418-1206
Phone (616) 320-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801097966MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Eating Disorder Specialists Social Worker CurrentSince May 18, 2022 Accepting new patients

Locations

1861 Rw Berends Dr SW
Wyoming, MI 49519
Phone (616) 259-5387

2905 Wilson Ave SW
Ste 252
Wyoming, MI 49418
Phone (616) 284-1202

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1780064121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181295",
            "telephone_number": "616-320-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463664",
            "telephone_number": "169-577-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNETT",
        "first_name": "KASSIDY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801097966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.