Active NPI
Raeann Marie Besteman, LMSW
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1912445768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801104187
- Practice address
- 790 Fuller Ave NE
Grand Rapids, MI 49503-1918 - Phone
- (616) 328-4015
- NPI assigned
- Feb 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801104187 | MI | |
| Clinical Social Worker | 1041C0700X | 6801100131 | MI | |
| Social Worker | 104100000X | 6801104187 | MI | Primary |
Addresses
Primary practice location
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Mailing address
1201 3Rd St NW
Grand Rapids, MI 49504-5033
Phone (616) 328-4015
Other practice location 1
1131 Ionia Ave NW
Grand Rapids, MI 49503-1020
Phone (616) 259-7900
Other practice location 2
640 3 Mile Rd NW Ste G
Grand Rapids, MI 49544-8209
Phone (616) 369-8433
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801100131 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interact of Michigan, Inc | Past | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kalamazoo, MI
- NPI 1760419691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1912445768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 3RD ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045033",
"telephone_number": "616-328-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-328-4015"
}
],
"practiceLocations": [
{
"address_1": "1131 Ionia Ave NW",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495031020",
"country_code": "US",
"telephone_number": "616-259-7900",
"fax_number": "616-259-7909",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "640 3 Mile Rd NW Ste G",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495448209",
"country_code": "US",
"telephone_number": "616-369-8433",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BESTEMAN",
"first_name": "RAEANN",
"middle_name": "MARIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-01",
"last_updated": "2023-11-27",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801104187",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801100131",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801104187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.