KANDIS KOREEN DESHAW (LMSW) – Social Worker, NPI 1740550151

KANDIS KOREEN DESHAW (LMSW) is a healthcare provider. based in Wayland, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801093338 (MI). The NPI Number for KANDIS KOREEN DESHAW (LMSW) is 1740550151

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
KANDIS KOREEN DESHAW (LMSW)
NPI
1740550151
Phone
(616) 885-7155
Address
205 ALPINE ST
Enumeration Date
3 January 2012
Last Update Date
6 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8886657246
Graduation Year
2011 (15 years ago)
PAC ID
9739318536
Group Practice PAC ID
8426097049
Professional Enrollment ID
I20140127000566
Address ID
MI495462379GR710XXSEXX404
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:14State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

Provider Addresses for KANDIS KOREEN DESHAW (LMSW)

  • 205 ALPINE ST

    WAYLAND, MI 493481232

    Phone: (616) 885-7155

    Type: Mailing

  • 710 KENMOOR AVE SE STE 200

    GRAND RAPIDS, MI 495462379

    Phone: (616) 588-7246

    Type: Location

  • 100 Cherry St SE

    Grand Rapids, MI 495034526

    Phone: (616) 965-8200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-01-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140127000566IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49348)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426097049View full group profile
NameSpecialtyState
-MI
Clinical PsychologistMI
Clinical PsychologistMI
-MI

Reviews

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Frequently asked questions

Where can patients find KANDIS KOREEN DESHAW (LMSW)'s NPI?
You can confirm KANDIS KOREEN DESHAW (LMSW) with NPI 1740550151; it appears in the national provider directory.
Is KANDIS KOREEN DESHAW (LMSW) currently active in the NPI registry?
CMS-published data lists KANDIS KOREEN DESHAW (LMSW) as an active registrant.
What kind of provider is KANDIS KOREEN DESHAW (LMSW)?
The page reflects Social Worker for KANDIS KOREEN DESHAW (LMSW). Clinical services aligned with this taxonomy classification.
What location shows for KANDIS KOREEN DESHAW (LMSW)?
We surface Wayland, Michigan for KANDIS KOREEN DESHAW (LMSW) based on available NPPES addresses.
What if Wayland, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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