Provider Demographics
NPI:1073673513
Name:NEWTON-NORDER, KAREN ELIZABETH (LMSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:NEWTON-NORDER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ELIZABETH
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:300 68TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49548-6927
Mailing Address - Country:US
Mailing Address - Phone:616-455-5000
Mailing Address - Fax:616-455-5960
Practice Address - Street 1:300 68TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49548-6927
Practice Address - Country:US
Practice Address - Phone:616-455-5000
Practice Address - Fax:616-455-5960
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010855831041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF16408037Medicare PIN
MI20386Medicare UPIN
MI1712452Medicaid
MI20351Medicare UPIN
MI20378Medicare UPIN
MI750910902Medicare UPIN
MI750910482Medicare UPIN
MI20366Medicare UPIN
MI750910903Medicare UPIN
MI750910910Medicare UPIN
MI750910904Medicare UPIN