Kyle Boer, LMSW, CAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801115335 Issued in MI

Practice address

483 Century LN
Holland, MI 49423-4286

Phone

(616) 396-5284

NPI assigned

Feb 24, 2015

Last updated

Jan 10, 2024By the provider in NPPES

Sex

Male

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leadlight LLCGroup PAC ID 4284161233, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Leadlight LLC

  dba Leadlight Counseling

  • Mental Health Counselor
  • Holland, MI
  • NPI 1578279998
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1891187175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 CENTURY LN",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234286",
            "telephone_number": "616-796-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 CENTURY LN",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234286",
            "telephone_number": "616-396-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOER",
        "first_name": "KYLE",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-24",
        "last_updated": "2024-01-10",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph R Blodgett, M.D.
• Brittney Bloomquist
• Eleanor Elizabeth Blouw, CRNA
• David Jon Blystra
• Tracy Ann Bobo, LMSW
• Emily Boerman
• Jennifer Boerman
• Rachele Boerman
• Quinne Boersma, OTR
• Brian C Boeve

• Clinical Social Worker in Holland, MI
• Providers in Holland, 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 Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.