MRS. MICHELE RAE ANNE JACKSON (NPI# 1598193773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598193773 |
| Entity Type | Individual |
| Full Name | MRS. MICHELE RAE ANNE JACKSON |
| Credential | LMSW |
| Practice Address |
1870 Leonard St Ne Grand Rapids MI 49505-5650 |
| Mailing Address |
300 68th St Se Grand Rapids MI 49548-6927 |
| Practice Telephone | 6169569619 |
| Practice Fax Number | 6169568033 |
| Mailing Telephone | 6164555000 |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2018-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 99058975A | IN | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801095548 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1598193773 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669031753 | Michele Jackson | Social Worker | 2306 Verona Ct, Harker Heights, TX 76548-8855 | 2019-06-11 |
| 1477895084 | Michele Jackson | Registered Nurse | 21 23 Grand Street, Newburgh, NY 12550 | 2013-03-21 |
| 1013292929 | Michele Mary Jackson | Specialist | 5669 Wendy Cir, Lockport, NY 14094-6015 | 2011-10-12 |
| 1558855825 | Michele Jackson | Technician | 1701 N Green Valley Pkwy Ste 9a, Henderson, NV 89074-5991 | 2018-06-19 |
| 1558782920 | Michele Marie Jackson | Nurse Practitioner | 801 W 1st St, San Juan, TX 78589 | 2014-01-02 |
| 1740411636 | Michele Denise Jackson | Counselor | 10700 Macarthur Blvd, Ste 12, Oakland, CA 94605-5298 | 2009-07-27 |
| 1033214291 | Michele D Jackson | Physical Therapist | 1901 S Cedar St Ste B1, Tacoma, WA 98405-2305 | 2006-09-13 |
| 1346228376 | Michele Allyn Jackson | Nurse Practitioner | 12303 Ne 130th Ln, Suite 500, Kirkland, WA 98034-3099 | 2006-01-09 |
| Street Address |
1870 LEONARD ST NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992898001 | Pamela Ann Wright-hachet | Social Worker | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2006-10-02 |
| 1275171837 | Cindy S Urban | Counselor | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2019-12-13 |
| 1013560085 | Jason R Rood | Social Worker | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2019-07-18 |
| 1326522293 | Kristy Lee Gunnink | Counselor | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2018-09-18 |
| 1629505268 | Cassandra Marie Degraaf | Social Worker | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2017-05-14 |
| 1972057081 | Marci Gleason | Social Worker | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2016-08-05 |
| 1598138810 | Pine Rest Christian Mental Health Services | Counselor | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2015-11-09 |
| 1275886426 | Ian Nelson | Psychologist | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2012-10-24 |
| 1922359710 | Cherie M Keating | Social Worker | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2012-09-20 |
| 1043570344 | Wendy Bilgen | Social Worker | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2012-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639560 | Ananya Avinash | Social Worker | 235 Olivia Ct Nw, Grand Rapids, MI 49504-5897 | 2020-11-03 |
| 1982203485 | Becoming You Therapy Pllc | Social Worker | 2346 Mission Hills Dr Se, Grand Rapids, MI 49546-7804 | 2020-10-26 |
| 1235738774 | Huffman Counseling Services LLC | Social Worker | 1950 Waldorf St Nw Ste E, Grand Rapids, MI 49544-1488 | 2020-10-24 |
| 1730795816 | Elizabeth Anne Maher | Social Worker | 1519 Pontiac Rd Se, Grand Rapids, MI 49506-3367 | 2020-09-23 |
| 1437764511 | Titiana Shanee Richardson | Social Worker | 113 Lake Michigan Drive Northwest, Grand Rapids, MI 49544 | 2020-09-15 |
| 1205448834 | Rose Training & Education, LLC | Social Worker | 156 Hillview Ave Ne, Grand Rapids, MI 49503-3824 | 2020-08-17 |
| 1497366967 | Krista L. Leinberger, LLC | Social Worker | 548 Fairview Ave Ne Apt 1, Grand Rapids, MI 49503-2581 | 2020-08-10 |
| 1609493782 | Lauren Anne Tarkiewicz | Social Worker | 700 Alger St Se, Grand Rapids, MI 49507-3531 | 2020-07-06 |
| 1841814779 | Molly Ballantyne | Social Worker | 1166 Hall St Se, Grand Rapids, MI 49507-1971 | 2020-06-06 |
| 1942839238 | Patricia Hickey Msw | Social Worker | 2020 Raybrook St Se Ste 301, Grand Rapids, MI 49546-7717 | 2020-04-07 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.