Individual provider Active NPI

Jonathan Kevin Englund, LLMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1972165595
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801104266 Issued in MI
Practice address
1620 44TH St SE
Grand Rapids, MI 49508-5002
Phone
(989) 657-1272
NPI assigned
Jul 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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 6801104266 MI Primary

Addresses

Primary practice location

1620 44TH St SE
Grand Rapids, MI 49508-5002

Mailing address

541 Bayberry Pointe Dr NW Apt F
Grand Rapids, MI 49534-8005
Phone (989) 657-1272

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801104266MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1972165595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 BAYBERRY POINTE DR NW APT F",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495348005",
            "telephone_number": "989-657-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 44TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495085002",
            "telephone_number": "989-657-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLUND",
        "first_name": "JONATHAN",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104266",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.