Individual provider Active NPI

Chandra Lynne Doorn Criffield, LMSW

  • Clinical Social Worker
  • Kentwood, MI
National Provider Identifier
1912269028
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087706 Issued in MI
Practice address
5951 Stonyhill LN SE
Kentwood, MI 49508-6462
Phone
(616) 706-9223
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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 6801087706 MI Primary

Addresses

Primary practice location

5951 Stonyhill LN SE
Kentwood, MI 49508-6462

Mailing address

5951 Stonyhill LN SE
Kentwood, MI 49508-6462
Phone (616) 706-9223

Other names 1

  • Chandra Lynne Doorn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801087706MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Therapeutic Services, PLLC Clinical CurrentSince Aug 28, 2021 Accepting new patients

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1912269028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5951 STONYHILL LN SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086462",
            "telephone_number": "616-706-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5951 STONYHILL LN SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086462",
            "telephone_number": "616-706-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIFFIELD",
        "first_name": "CHANDRA",
        "middle_name": "LYNNE DOORN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANDRA",
            "last_name": "DOORN",
            "middle_name": "LYNNE",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.