D a Blodgett-St Johns
Organization Active NPI Clinical Social Worker · Grand Rapids, MI
NPI 1801929435 · NPPES record last updated Apr 26, 2023
Key facts
- NPI
- 1801929435
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CB410201088 (MI)
- Legal business name
- D A BLODGETT-ST JOHNS
- Practice address
- 2172 Dean Lake Ave NE
Grand Rapids, MI 49505-4444 - Phone
- (616) 451-2021
- Fax
- (616) 774-3842
- NPI assigned
- Mar 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Tammy Smith
- Title
- Director of Finance
- Phone
- (616) 451-2021
Practitioners 140
-
Sarah Jean Adkison, BSW
-
Kelsey Amick, LLMSW
-
Samuel Brouwer, LLMSW
-
Keylaiha Brown, LLMSW
-
Caitlin Brummel, BSW, QIDP
-
Hayley Burns, BS
-
Sierra Lynn Clouse, LMSW
-
Marisa Leigh Conklin, BSW
-
Grace Kristina Frank, CTRS
-
Sarah Gibson, LLMSW
-
Savannah Gorton, BSW
-
Breanna Harris, BS
-
Rachel Hines, MOT
-
Dana Christine Hulst, BS, CTRS, QIDP
National Provider Directory
Locations
2172 Dean Lake Ave NE
Grand Rapids, MI 49505
Phone (616) 451-2021
805 Leonard St NE
Grand Rapids, MI 49503
Phone (616) 451-2021
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | CB410201088 | MI | Yes |
Addresses
Primary practice location
2172 Dean Lake Ave NE
Grand Rapids, MI 49505-4444
Mailing address
2172 Dean Lake Ave NE
Grand Rapids, MI 49505-4444
Phone (616) 451-2021
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3243343 | Medicaid | MI | |
| 4486650 | Medicaid | MI | |
| 4537919 | Medicaid | MI |
Other names
- D.A. Blodgett For Children
Other providers in Grand Rapids, MI
- Bethany Emalia Czerny
- Diane Czuk-Smith
- Rebecca Czyz
- Lindsay Marie Czyzyk
- D & J Dental Holdings PLLC
- D H Anesthesia Services
- D.a. Blodgett - St. John'S
- Steve D'Orazio
- Ashley D'Souza
- D&M Hispanic Dental Office BLDG LLC
All providers in Grand Rapids, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.