Kelli Blanchard, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801088357 Issued in MI

Practice address

200 Eastern Ave SE
Grand Rapids, MI 49503-4735

Phone

(616) 776-0891

Fax

(616) 233-0672

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Solidarity Therapy Services LLC

  • Clinical Social Worker
  • Evanston, IL
  • NPI 1801420971
  NPD Authorized official
• Life Guidance Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1336185032
  NPD (past)
• Project Rehab

  • Substance Abuse Rehabilitation Facility
  • Grand Rapids, MI
  • NPI 1104986603
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972710291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034737",
            "telephone_number": "616-776-0891",
            "fax_number": "616-233-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034735",
            "telephone_number": "616-776-0891",
            "fax_number": "616-233-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "KELLI",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801088357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaunna Dior Blake
• Tai Blake, RN
• Barbara B Blakely, PA-C
• Stephanie Michelle Blakemore
• Danielle J Blanchard
• Meghan Marie Blanchard, LMSW
• Rachelle Renea Blanchard, PA-C
• Ashley Blanchette, PHARMD
• Lauren Marie Blanck, MD
• Taylor Marie Blank, DNP, FNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.