Individual provider Active NPI

Jessica Joy Marvin, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1902507908
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119681 Issued in MI
Practice address
678 Front Ave NW Ste 100
Grand Rapids, MI 49504-5323
Phone
(616) 916-3711
NPI assigned
Mar 15, 2023
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6851116156 MI
Clinical Social Worker 1041C0700X 6801119681 MI Primary

Addresses

Primary practice location

678 Front Ave NW Ste 100
Grand Rapids, MI 49504-5323

Mailing address

2084 Fawnwood Dr SE
Kentwood, MI 49508-6516
Phone (616) 826-1351

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
I20260518003348 MI Practitioner - Clinical Social Worker 7911476072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1457 Hazen St SE
Grand Rapids, MI 49507-3712

333 Bridge St NW
Suite 1120
Grand Rapids, MI 49504-5356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851116156MIMDMental Health Counselor
6801119681MIMDClinical Social Worker

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

NPI Registry JSON

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1902507908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 FAWNWOOD DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086516",
            "telephone_number": "616-826-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 FRONT AVE NW STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045323",
            "telephone_number": "616-916-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "JESSICA",
        "middle_name": "JOY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6851116156",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.