Individual provider Active NPI

Lisa R Baker, LCMS, BC-TMH

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1962988030
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087395 Issued in MI
Practice address
1115 Alto Ave SE
Grand Rapids, MI 49507-1403
Phone
(616) 443-3853
NPI assigned
Jul 12, 2018
Last updated
Jul 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801087395 MI Primary

Addresses

Primary practice location

1115 Alto Ave SE
Grand Rapids, MI 49507-1403

Mailing address

5085 Sunny Creek CT SE
Grand Rapids, MI 49508-4972
Phone (616) 443-3853

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
I20210927002713 MI Practitioner - Clinical Social Worker 2961809496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inspiring U Therapy, LLC Clinical CurrentSince Jun 19, 2021 Accepting new patients

Locations

1115 Alto Ave SE
Grand Rapids, MI 49507
Phone (616) 443-3853

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1962988030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5085 SUNNY CREEK CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495084972",
            "telephone_number": "616-443-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ALTO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071403",
            "telephone_number": "616-443-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "LCMS, BC-TMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.