Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Philip Dezern

Individual provider Social Worker · NPI 1295509859

Philip Dezern is a Clinical Social Worker in Grand Rapids, Michigan. Qualified in 2009, 17 years ago. Licensed in Michigan.

Years since qualifying
17
Licensed in
MI
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5020 E Beltline Ave NE
Grand Rapids, MI 49525-6869
Phone: (616) 439-1866
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 6851093862 (MI)

Record details

NPI number1295509859
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 14, 2023
Last updated in NPPESNovember 14, 2023
Certification dateNovember 11, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Grand Rapids