Individual provider Active NPI

Elizabeth Ruth Smith, LMSW

  • Clinical Social Worker
  • Kentwood, MI
National Provider Identifier
1932656972
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098861 Issued in MI
Practice address
1945 Ramblewood CT SE
Kentwood, MI 49508-6532
Phone
(616) 881-9523
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 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 6801098861 MI Primary

Addresses

Primary practice location

1945 Ramblewood CT SE
Kentwood, MI 49508-6532

Mailing address

1945 Ramblewood CT SE
Kentwood, MI 49508-6532
Phone (616) 881-9523

Other practice location 1

550 Cascade West Pkwy SE
Grand Rapids, MI 49546-2137
Phone (616) 930-4123

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
I20191008002138 MI Practitioner - Clinical Social Worker 9739410671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Burke Group Counseling and Consulting Professionals LLCGroup PAC ID 6103190335, 16 clinicians

Practice addresses (Care Compare)

4124 56TH St SW
Suite 4
Wyoming, MI 49418-9494
Phone (616) 222-0631

756 Fulton St W
Grand Rapids, MI 49504-6404
Phone (616) 222-0631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Group Counseling & Consulting Professionals LLC Clinical CurrentSince Feb 1, 2022 Accepting new patients
David W Hamilton PSYD PLLC PastSince Oct 1, 2019 Accepting new patients

Locations

756 Fulton St W
Ste 201
Grand Rapids, MI 49504
Phone 6162220631 ext. 702

756 Fulton St W
Grand Rapids, MI 49504
Phone (616) 222-0631

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1932656972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 RAMBLEWOOD CT SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086532",
            "telephone_number": "616-881-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 RAMBLEWOOD CT SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086532",
            "telephone_number": "616-881-9523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Cascade West Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495462137",
            "country_code": "US",
            "telephone_number": "616-930-4123",
            "fax_number": "616-323-3994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "RUTH",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

Verify at the official NPI Registry.