Roshel Catia Stafford, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801108759 Issued in MI

Practice address

3124 N Wellness Dr Ste 60
Holland, MI 49424-8121

Phone

(616) 805-3660

Fax

(616) 805-3631

NPI assigned

Oct 5, 2016

Last updated

Jul 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Roshel Catia Wagner Former name

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  Medicare reassignment Care Compare group NPD
• Jack a Dekkinga MD PC

  dba West Michigan Dermatology

  • Dermatology Physician
  • Grandville, MI
  • NPI 1609896034
  NPD (past)
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1912457623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR STE 60",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-805-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR STE 60",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 Leonard St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495031129",
            "country_code": "US",
            "telephone_number": "616-454-4777",
            "fax_number": "616-458-8039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "ROSHEL",
        "middle_name": "CATIA",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSHEL",
            "last_name": "WAGNER",
            "middle_name": "CATIA",
            "prefix": "MS.",
            "credential": "LLBSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blake Rushford Spooner, D.C.
• Samantha Jo Spooner, D.C.
• Holly Jean Sprick, RN
• Ashley Nichole St Andrew, PHARM.D
• Stacy McNeely LMSW PLC
• Donald Leroy Stageman, M.D.
• Brittany Stahl
• Khristine Stanek
• James Stark, LMSW, CAADC
• James Marshall Stark, PT

• Clinical Social Worker in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.