Blueberry Hill Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUEBERRY HILL COUNSELING LLC

Practice address

1337 Quarry Ave NW Apt 1
Grand Rapids, MI 49504-3133

Phone

(616) 439-1872

NPI assigned

Jan 25, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Flavio Da Silva, LMSWNPI 1053750695

Title

Owner

Phone

(616) 439-1872

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Flavio Manoel Da Silva, LMSW, CAADC

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1053750695
  Medicare reassignment NPD Authorized official
• Aubri Elise Bates, MSW

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1154779478
  NPD (past)

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1972255578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 QUARRY AVE NW APT 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495043133",
            "telephone_number": "616-439-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 QUARRY AVE NW APT 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495043133",
            "telephone_number": "616-439-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBERRY HILL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "DA SILVA",
        "authorized_official_first_name": "FLAVIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-439-1872",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandon Blue
• Chloe Mae Blue
• Allison Blumenfeld, MD
• Tara Blury, MSW, LMSW, TF-CBT
• Michelle Lee Blystone, OTR/L
• Claire Elizabeth Blystra
• BMSC Mi LLC

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.