JACK DURRELL DANIELS
NPI 1457215535
Case Manager/Care Coordinator in Grand Rapids, MI

Q: What is Jack Daniels's NPI number?

The NPI number for Jack Daniels is 1457215535. It was assigned to this individual provider in the NPPES registry on December 12, 2025.

Q: What is Jack Daniels's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Daniels was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since December 12, 2025

1115 BALL AVE NE, GRAND RAPIDS, MI 49505(616) 456-6571 Get Directions Write a Review

NPPES record last updated: December 12, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Jack Durrell Daniels NPPES

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

JACK DURRELL DANIELS (NPI 1457215535) is an individual case manager/care coordinator provider in Grand Rapids, Michigan and active in the NPI registry since December 2025.

NPPES Registry Identity

NPI1457215535

Entity TypeIndividualMale

Primary Taxonomy171M00000X

Provider Legal NameJACK DURRELL DANIELS

Location Address1115 BALL AVE NEGrand Rapids, MI 49505-5904

Mailing Address1115 Ball Ave NeGrand Rapids, MI 49505-5904 · (616) 456-6571

Phone(616) 456-6571

Sole ProprietorNo

Enumeration DateDecember 12, 2025

NPPES CertifiedDecember 12, 2025

✔ NPI 1457215535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

1115 BALL AVE NE, Grand Rapids, MI 49505

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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.

JAMIE MARIE HENSON BSW

Social Worker

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 240-1990

KATHARINE ELISABETH DANIELS

Social Worker

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 456-6571

TODD JOHNSON

Counselor (Addiction (Substance Use Disorder))

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 456-6571

JOHN HUNT

Social Worker

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 456-7775

TAYLOR BERGBOWER

Social Worker

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 456-1443

MRS. KELLY SUE BOPRIE LMSW

Social Worker (Clinical)

1115 BALL AVE NE, BUILDING C
GRAND RAPIDS, MI 49505

Kent County (616) 459-7215

KATHLEEN MONROE

Counselor

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 456-6571

EMILY SALZMAN LMSW

Social Worker (Clinical)

1115 BALL AVE NE
GRAND RAPIDS, MI 49505

Kent County (616) 451-3001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Daniels's NPI number?

The NPI number for Jack Daniels is 1457215535. It was assigned to this individual provider in the NPPES registry on December 12, 2025.

Where is Jack Daniels located?

Jack Daniels practices at 1115 Ball Ave NE, Grand Rapids, MI 49505. The listed phone number is (616) 456-6571.

What is Jack Daniels's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Jack Daniels was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.