Martha Pettijohn Anderson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091266 Issued in MI

Practice address

3215 Eagle Crest Dr NE
Grand Rapids, MI 49525-7005

Phone

(616) 456-5664

NPI assigned

Dec 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Area Agency on Aging of Western Michigan Inc.

  • Case Management Agency
  • Grand Rapids, MI
  • NPI 1174965115
  NPD

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1851050686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 FERNRIDGE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463876",
            "telephone_number": "616-988-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 EAGLE CREST DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257005",
            "telephone_number": "616-456-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARTHA",
        "middle_name": "PETTIJOHN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa E. Anderson
• Luke Britton Anderson
• Madeline Anderson, DPT
• Mallory Anderson
• Marcelyn Anderson, PA-C
• Michael Robert Anderson Jr., D.C.
• Nathaniel Joel Anderson
• Paula Anderson
• Richard Gregory Anderson, LMSW
• Ricky Anderson

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.