Individual provider Active NPI

Elizabeth Maitner Nielsen, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1982256087
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801103040 Issued in MI
Practice address
360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214
Phone
(616) 805-3660
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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 6801103040 MI Primary

Addresses

Primary practice location

360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214

Mailing address

PO Box 295
Rockford, MI 49341-0295
Phone (616) 821-7539

Other practice location 1

320 Commerce Ave SW
Grand Rapids, MI 49503-4101
Phone (616) 258-7599 ext. 7221

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
I20220728003034 MI Practitioner - Clinical Social Worker 6507248101 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801103040MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Apr 27, 2022 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

233 Fulton St E
Ste 526
Grand Rapids, MI 49503
Phone (616) 426-9193

3333 Deposit Dr NE
Ste 120
Grand Rapids, MI 49546
Phone (616) 940-3313

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

65 S Main St
Ste A
Rockford, MI 49341

502 Northland Dr NE
Ste 100
Rockford, MI 49341
Phone (616) 617-3321

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1982256087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493410295",
            "telephone_number": "616-821-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061214",
            "telephone_number": "616-805-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Commerce Ave SW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034101",
            "country_code": "US",
            "telephone_number": "616-258-7599 x7221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "ELIZABETH",
        "middle_name": "MAITNER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.