Active NPI
Janice Bentley, PSYD LMSW
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1952456402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801063539
- Practice address
- 2828 Kraft Ave SE
Suite 186
Grand Rapids, MI 49512-7700 - Phone
- (616) 949-9550
- Fax
- (616) 949-9551
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801063539 | MI | Primary |
Addresses
Primary practice location
2828 Kraft Ave SE
Suite 186
Grand Rapids, MI 49512-7700
Mailing address
PO Box 1767
Grand Rapids, MI 49501-1767
Phone (616) 235-2090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8008943530 | Other | MI | BCBSM PROVIDER |
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 |
|---|---|---|---|
| 6801063539 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474934400000",
"number": "1952456402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1767",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495011767",
"telephone_number": "616-235-2090",
"fax_number": "616-235-2099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 KRAFT AVE SE",
"address_2": "SUITE 186",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495127700",
"telephone_number": "616-949-9550",
"fax_number": "616-949-9551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "JANICE",
"credential": "PSYD LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2016-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801063539",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM PROVIDER",
"identifier": "8008943530",
"state": "MI"
}
],
"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 Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.