MEDICARE: DEBRA SUE ANSON LMSW, RAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW22225	FL
2	1041C0700X	Clinical Social Worker	6801095960	MI

General Provider Information

NPI Number	:	1538594015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA SUE ANSON LMSW, RAC

Provider Business Mailing Address
First Line	:	1971 E BELTLINE AVE NE STE 106
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-7045
Country	:	US
Telephone Number	:	162-682-7876
Fax Number	:

Provider Business Practice Location Address
First Line	:	1971 E BELTLINE AVE NE STE 106
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-7045
Country	:	US
Telephone Number	:	616-268-2787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	05/22/2025

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