Organization Active NPI

Heartstone Guidance Center LLC

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1831605567
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HEARTSTONE GUIDANCE CENTER LLC
Practice address
233 Fulton St E Ste 222
Grand Rapids, MI 49503-3262
Phone
(616) 490-3468
NPI assigned
Dec 18, 2017
Last updated
Feb 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

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

Authorized official

Name
Michael Shawn Barnes
Title
Credentialing
Phone
(616) 490-3468

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

233 Fulton St E Ste 222
Grand Rapids, MI 49503-3262

Mailing address

233 Fulton St E Ste 222
Grand Rapids, MI 49503-3262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430000363 MI Part B Supplier - Clinic/Group Practice 9739519943 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

2020 Raybrook St SE
Ste 102-3
Grand Rapids, MI 49546
Phone (616) 490-3468

233 Fulton St E
Ste 222
Grand Rapids, MI 49503
Phone (616) 490-3468

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675555200000",
    "number": "1831605567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E STE 222",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E STE 222",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033262",
            "telephone_number": "616-490-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTSTONE GUIDANCE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "616-490-3468"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.