Organization Active NPI

Inner Access Therapy Center LLC

  • Clinical Social Worker
  • Ionia, MI
National Provider Identifier
1780633149
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INNER ACCESS THERAPY CENTER LLC
Practice address
453 Dildine Rd
Ionia, MI 48846-9564
Phone
(616) 235-2090
Fax
(616) 235-2099
NPI assigned
May 10, 2006
Last updated
Jun 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Kim K Swisher
Title
Billing
Phone
(616) 235-2090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

453 Dildine Rd
Ionia, MI 48846-9564

Mailing address

112 S Depot St
Ionia, MI 48846-1636
Phone (616) 235-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040817001004 MI Part B Supplier - Clinic/Group Practice 4082687199 Receives reassigned benefits from 1 practitioner
Practice locations: Ionia, MI

National Provider Directory

National Provider Directory

Locations

112 S Depot St
Ionia, MI 48846
Phone (616) 527-2619

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1780633149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S DEPOT ST",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488461636",
            "telephone_number": "616-235-2090",
            "fax_number": "616-235-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 DILDINE RD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488469564",
            "telephone_number": "616-235-2090",
            "fax_number": "616-235-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER ACCESS THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "SWISHER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "616-235-2090"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ionia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.