BRONSON LAKEVIEW HOSPITAL (NPI# 1639313174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639313174 |
| Entity Type | Organization |
| Organization Name | BRONSON LAKEVIEW HOSPITAL |
| Other Organization Name | BRONSON LAKEVIEW HOSPITAL BEHAVIORAL HEALTH |
| Practice Address |
404 Hazen St Suite L3 Paw Paw MI 49079-1040 |
| Mailing Address |
301 John St Box 42 Kalamazoo MI 49007-5295 |
| Practice Telephone | 2696571595 |
| Practice Fax Number | 2696571534 |
| Mailing Telephone | 2693417806 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2016-07-14 |
| Authorized Official Name | REBECCA EAST (SVP,CFO) |
| Authorized Official Telephone | 2693416000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BRONSON LAKEVIEW HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0H010630 | 01 |
| Other Name | Type Code |
|---|---|
| Bronson LakeView Hospital Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104459627 | Bronson Lakeview Hospital | Clinic/Center | 520 Railroad St, Bangor, MI 49013-1490 | 2020-02-13 |
| 1740424068 | Bronson Lakeview Hospital | Nurse Anesthetist, Certified Registered | 601 John St, Box 42, Kalamazoo, MI 49007-5341 | 2009-04-30 |
| 1376767285 | Bronson Lakeview Hospital | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2007-04-12 |
| 1629292446 | Bronson Lakeview Hospital | Family Medicine | 310 White Oak Rd, Lawton, MI 49065-9705 | 2007-04-12 |
| 1538383351 | Bronson Lakeview Hospital | Family Medicine | 110 E Main St, Marcellus, MI 49067-8523 | 2007-04-12 |
| 1447474267 | Bronson Lakeview Hospital | Family Medicine | 52375 N Main St, Mattawan, MI 49071-9332 | 2007-04-12 |
| 1356565170 | Bronson Lakeview Hospital | General Acute Care Hospital | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2007-04-12 |
| 1750482444 | Bronson Lakeview Hospital | Psychiatric Unit | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-09-26 |
| 1962508259 | Bronson Lakeview Hospital | General Acute Care Hospital | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-09-15 |
| 1235131137 | Bronson Lakeview Hospital | Nurse Practitioner | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2005-08-11 |
| Street Address |
404 HAZEN ST SUITE L3 |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-1040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159597 | Nadeem M Mirza | Psychiatry & Neurology | 404 Hazen St, Suite 104, Paw Paw, MI 49079-1040 | 2005-07-29 |
| 1346510252 | Lisa Rae Woodruff | Nurse Practitioner | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2012-01-09 |
| 1477762441 | Rebecca L Thoreson | Surgery | 404 Hazen St, Suite 101, Paw Paw, MI 49079-1040 | 2007-05-22 |
| 1265656086 | Lakeview Community Hospital Authority | Surgery | 404 Hazen St, Suite 101, Paw Paw, MI 49079-1040 | 2007-04-12 |
| 1881706273 | Michael Kruk | Social Worker | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2006-08-31 |
| 1427161314 | Barbara L Thompson | Pharmacist | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-16 |
| 1710090519 | Jennifer L Sampsell | Pharmacy Technician | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-16 |
| 1376554881 | Skinner & Hang Inc | Pharmacy | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-10 |
| 1043228174 | Patrick Michael Lynch | Pharmacist | 404 Hazen St, Suite 102, Paw Paw, MI 49079-1040 | 2006-08-04 |
| 1104845239 | Paul Stephen Costanzo | Physician Assistant | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2006-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
| Find all providers in zip 49079 | ||||
| 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 |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1174051619 | Kanaan Therapy and Behavioral Health Services, LLC | Social Worker | 816 East Michigan Avenue, Suite 103, Paw Paw, MI 49079-9510 | 2017-05-29 |
| 1437552650 | Christine Roach-brown | Social Worker | 50739 Crescent Ave, Paw Paw, MI 49079-9569 | 2014-10-01 |
| 1588763973 | Ann M Leary | Social Worker | 53292 Meadow View Ln, Paw Paw, MI 49079-8642 | 2006-09-21 |
| 1013905959 | Laurie Cone French | Social Worker | 181 W Michigan Ave, Suite 3, Paw Paw, MI 49079-1432 | 2005-10-13 |
| 1316578966 | Blaire Leeanne Phillips | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2020-02-03 |
| 1376058792 | Taylor Foco | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2017-12-07 |
| 1508371006 | Elizabeth Courtney | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2017-12-06 |
| 1932625043 | Debra Lynn Koning | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2017-08-21 |
| 1871033936 | Karen Riffer-reinert | Social Worker | 801 Hazen St, Suite C, Paw Paw, MI 49079-2008 | 2017-03-08 |
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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.