Active NPI
Maribel Andrade
- Social Worker
- Grand Rapids, MI
National Provider Identifier
1992449003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801108193
- Practice address
- 1050 36TH St SE Ste 400
Grand Rapids, MI 49508-5581 - Phone
- (616) 965-8055
- Fax
- (616) 280-3262
- NPI assigned
- Apr 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801108193 | MI | Primary |
Addresses
Primary practice location
1050 36TH St SE Ste 400
Grand Rapids, MI 49508-5581
Mailing address
2450 Van Ommen Dr Ste C
Holland, MI 49424-8085
Phone (616) 350-7781
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801108193 | MI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethany Christian Services USA, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Foster Care Agency
- Grand Rapids, MI
- NPI 1790055788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1992449003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 VAN OMMEN DR STE C",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494248085",
"telephone_number": "616-350-7781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 36TH ST SE STE 400",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495085581",
"telephone_number": "616-965-8055",
"fax_number": "616-280-3262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRADE",
"first_name": "MARIBEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-25",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801108193",
"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 Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.