Emiley Jo Eisen, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801085834 Issued in MI

Practice address

1331 Lake Dr SE
Grand Rapids, MI 49506-1674

Phone

(616) 459-7215

Fax

(616) 451-0020

NPI assigned

Mar 26, 2007

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

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.

• Arbor Circle Corporation

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1740585330
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861510109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 R W BERENDS DR SW APT 4",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495196516",
            "telephone_number": "616-406-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 LAKE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061674",
            "telephone_number": "616-459-7215",
            "fax_number": "616-451-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEN",
        "first_name": "EMILEY",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Jon Eickhoff, PTA
• Celine T Eid, MD
• David Eidt
• Elisabeth Marie Eimer, MA/CCC-A
• Michael Eischens
• Richard Bruce Eisen, LMSW
• Lauren Elizabeth Eisenbarth, LMSW
• Bernard Henry Eisenga, M.D.
• Kathleen Marie Eisin, D.D.S, M.S.,PLLC
• Jessica H Eisma, MD

• 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 Jul 8, 2007; 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.