Individual provider Active NPI

Joanne Kathrine Vanderveen, MASTERS SOCIAL WORKE

  • Clinical Social Worker
  • Wyoming, MI
National Provider Identifier
1891914743
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086706 Issued in MI
Practice address
4289 Limousin CT SW
Wyoming, MI 49418-8746
Phone
(616) 634-8372
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801086706 MI Primary

Addresses

Primary practice location

4289 Limousin CT SW
Wyoming, MI 49418-8746

Mailing address

4289 Limousin CT SW
Wyoming, MI 49418-8746
Phone (616) 634-8372

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231221000864 MI Practitioner - Clinical Social Worker 3274983994 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801086706MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Dec 5, 2023 Accepting new patients

Locations

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1891914743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4289 LIMOUSIN CT SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494188746",
            "telephone_number": "616-634-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4289 LIMOUSIN CT SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494188746",
            "telephone_number": "616-634-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVEEN",
        "first_name": "JOANNE",
        "middle_name": "KATHRINE",
        "name_prefix": "Mrs.",
        "credential": "MASTERS SOCIAL WORKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.