MRS. MALLORY MAE BOUWMAN LMSW - NPI 1215301411 - Social Worker in Grand Rapids, MI

Q: What is Mallory Bouwman's NPI number?

The NPI number for Mallory Bouwman is 1215301411. It was assigned to this individual provider in the NPPES registry on November 25, 2015.

Q: What is Mallory Bouwman's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Bouwman was last updated on December 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Mrs. Mallory Mae Bouwman Lmsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MALLORY MAE BOUWMAN LMSW (NPI 1215301411) is an individual clinical provider in Grand Rapids, Michigan, licensed in Michigan (6801095229) and active in the NPI registry since November 2015.

NPPES Registry Identity

NPI1215301411

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. MALLORY MAE BOUWMANCredential: LMSW

Location Address385 LEONARD ST NEGrand Rapids, MI 49503-1129

Mailing Address5447 Lilly Ct SwWyoming, MI 49509-9200 · (616) 389-2723 · Fax (616) 454-2554

Phone(616) 389-2723

Fax(616) 454-2554

Sole ProprietorNo

Enumeration DateNovember 25, 2015

Last NPPES UpdateDecember 16, 20203 updates tracked since enumeration

NPPES CertifiedDecember 16, 2020

✔ NPI 1215301411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MI · 6801095229

Definition

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.

Also ListedSocial WorkerTaxonomy 104100000X · License 6801095229 (MI)

385 LEONARD ST NE, Grand Rapids, MI 49503

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE BEASLEY

Social Worker (Clinical)