Individual provider Active NPI

Jessica Lynn Sevic, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1902322308
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110694 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 258-7569
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801104590 MI
Social Worker 104100000X 6802088576
Clinical Social Worker 1041C0700X 6801110694 MI Primary

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other practice location 1

320 Commerce Ave. SW
Grand Rapids, MI 49503
Phone (616) 258-7569

Other practice location 2

4211 Parkway Place Dr SW
Grandville, MI 49418-2695
Phone (616) 222-3700

Other practice location 3

6505 Cherry Meadow Dr SE
Caledonia, MI 49316-9484
Phone (616) 891-8770

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
I20210816002497 MI Practitioner - Clinical Social Worker 4385049212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801104590MIMDSocial Worker
6801110694MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Jul 20, 2021 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Jul 20, 2021 Accepting new patients

Locations

6505 Cherry Meadow Dr SE
Caledonia, MI 49316
Phone (616) 644-0787

320 Commerce Ave SW
Grand Rapids, MI 49503
Phone (616) 222-4570

4211 Parkway Place Dr SW
Grandville, MI 49418
Phone (616) 222-3700

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 2

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": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1902322308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-258-7569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Commerce Ave. SW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49503",
            "country_code": "US",
            "telephone_number": "616-258-7569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4211 Parkway Place Dr SW",
            "address_purpose": "LOCATION",
            "city": "Grandville",
            "state": "MI",
            "postal_code": "494182695",
            "country_code": "US",
            "telephone_number": "616-222-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6505 Cherry Meadow Dr SE",
            "address_purpose": "LOCATION",
            "city": "Caledonia",
            "state": "MI",
            "postal_code": "493169484",
            "country_code": "US",
            "telephone_number": "616-891-8770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVIC",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801104590",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "6802088576",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.