Individual provider Active NPI

Christine Sue Heffron, LMSW

  • Social Worker
  • Kalamazoo, MI
National Provider Identifier
1932766136
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801093479 Issued in MI
Practice address
5360 Holiday Ter Ste 32
Kalamazoo, MI 49009-2126
Phone
(269) 251-1494
NPI assigned
May 22, 2019
Last updated
May 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801093479 MI Primary
Clinical Social Worker 1041C0700X 6801093479 MI

Addresses

Primary practice location

5360 Holiday Ter Ste 32
Kalamazoo, MI 49009-2126

Mailing address

58295 Kristina Cir W
Paw Paw, MI 49079-8605
Phone (269) 929-0210

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
I20241126000832 MI Practitioner - Clinical Social Worker 3173058211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Counseling and Psychotherapy, PLLCGroup PAC ID 1355772385, 5 clinicians

Practice addresses (Care Compare)

721 W Centre Ave
Portage, MI 49024-5309
Phone 26977975775309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093479MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Counseling and Psychotherapy, PLLC Clinical CurrentSince Oct 1, 2024 Accepting new patients

Locations

487 S Drake Rd
Ste B
Kalamazoo, MI 49009
Phone (269) 779-7577

721 W Centre Ave
Portage, MI 49024
Phone (269) 330-7030

8145 Valleywood Ln
Ste B
Portage, MI 49024
Phone (269) 234-2343

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": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1932766136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58295 KRISTINA CIR W",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798605",
            "telephone_number": "269-929-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 HOLIDAY TER STE 32",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092126",
            "telephone_number": "269-251-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFRON",
        "first_name": "CHRISTINE",
        "middle_name": "SUE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801093479",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.