Victoria Grace Hodge, LMSW
Individual provider Active NPI Clinical Social Worker · Beaverton, MI
NPI 1871298596 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1871298596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801115238 (MI)
- Practice address
- 440 S Ross St
Beaverton, MI 48612-9101 - Phone
- (989) 246-3020
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250429003031 | MI | Practitioner - Clinical Social Worker | 0840716197 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801115238 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801115238 | MI | Yes |
Addresses
Primary practice location
440 S Ross St
Beaverton, MI 48612-9101
Mailing address
2901 W Howard Rd
Beaverton, MI 48612-9777
Phone (248) 978-3596
Other providers in Beaverton, MI
- Family Health & Wellness PC
- Cody Fryzel
- Sheila Gordon
- Danny D Greig II
- Justin Hampel
- Alexander Hull
- Kindling Hope Counseling, PLLC
- Susan M Knoerr
- Arlene Lynn Krager
- Rosemary McCallum-Herbert
All providers in Beaverton, 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 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.