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790 Fuller Ave Ne Grand Rapids MI 49503-1918 | |
| (616) 336-3909 | |
| (616) 336-8830 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 790 Fuller Ave Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | William Joseph Ward (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6168555201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
790 Fuller Ave Ne Grand Rapids MI 49503-1918 Ph: (616) 336-3909 | 790 Fuller Ave Ne Grand Rapids MI 49503-1918 Ph: (616) 336-3909 |
| NPI Number | 1588935068 |
|---|---|
| Provider Enumeration Date | 01/16/2012 |
| Last Update Date | 09/27/2019 |
| Medicare PECOS PAC ID | 9436314143 |
|---|---|
| Medicare Enrollment ID | O20120703000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588935068 | NPI | - | NPPES |
| 4483587 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Robert D Holwerda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205995735 PECOS PAC ID: 7416860762 Enrollment ID: I20031112000025 |
| Provider Name | Scott Monteith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104866227 PECOS PAC ID: 4789598152 Enrollment ID: I20031119000083 |
| Provider Name | Dawn M Rasmussen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326123803 PECOS PAC ID: 2163410499 Enrollment ID: I20040517001071 |
| Provider Name | Bobga S Fomunung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700899010 PECOS PAC ID: 1153387667 Enrollment ID: I20041207000420 |
| Provider Name | Russel V Brubaker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437259793 PECOS PAC ID: 2860442274 Enrollment ID: I20050124000893 |
| Provider Name | Amy K Brace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154467868 PECOS PAC ID: 5193758241 Enrollment ID: I20050919000169 |
| Provider Name | Mazhar Munir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821083924 PECOS PAC ID: 4789789744 Enrollment ID: I20070419000357 |
| Provider Name | Jack A Mahdasian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841246634 PECOS PAC ID: 0840185070 Enrollment ID: I20080515000530 |
| Provider Name | Michael A Michelakis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235176249 PECOS PAC ID: 4981778701 Enrollment ID: I20080728000658 |
| Provider Name | Jillaine Ruppel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780816520 PECOS PAC ID: 9931255106 Enrollment ID: I20090914000607 |
| Provider Name | Radosveta Stoyanov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972652972 PECOS PAC ID: 0749240166 Enrollment ID: I20100701000514 |
| Provider Name | Jamie S Mclean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922205772 PECOS PAC ID: 0345321006 Enrollment ID: I20101210000946 |
| Provider Name | Daniel A Burgess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639470479 PECOS PAC ID: 7911196498 Enrollment ID: I20110114000138 |
| Provider Name | Robert S La Fleur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043260177 PECOS PAC ID: 8224219522 Enrollment ID: I20110218000995 |
| Provider Name | Aaron John Plattner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285891374 PECOS PAC ID: 8628251113 Enrollment ID: I20110902000588 |
| Provider Name | Laura K Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265725139 PECOS PAC ID: 3476728171 Enrollment ID: I20111207000878 |
| Provider Name | Dolores H Sneed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871752972 PECOS PAC ID: 0840447751 Enrollment ID: I20120829000104 |
| Provider Name | Michael R Rinker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245282425 PECOS PAC ID: 7012165962 Enrollment ID: I20120918000548 |
| Provider Name | Christina L White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588814123 PECOS PAC ID: 1153554761 Enrollment ID: I20140506002123 |
| Provider Name | Umer Farooq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487885513 PECOS PAC ID: 5092931956 Enrollment ID: I20140729002697 |
| Provider Name | Charleitte Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972843126 PECOS PAC ID: 4284850025 Enrollment ID: I20140730002714 |
| Provider Name | Melissa R Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932475340 PECOS PAC ID: 3678896321 Enrollment ID: I20150105000339 |
| Provider Name | Joshua A Godfrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023429198 PECOS PAC ID: 3476846338 Enrollment ID: I20160729001117 |
| Provider Name | Aniruddh P Behere |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265689897 PECOS PAC ID: 5092957308 Enrollment ID: I20170126001993 |
| Provider Name | Michelle J Volkers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356416176 PECOS PAC ID: 6800171232 Enrollment ID: I20170324002252 |
| Provider Name | Brooke H Gaddy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174941652 PECOS PAC ID: 5991076044 Enrollment ID: I20170808000660 |
| Provider Name | Melanie M Dennison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861915928 PECOS PAC ID: 4981975034 Enrollment ID: I20170808000698 |
| Provider Name | Rachelle G Bosma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023404134 PECOS PAC ID: 7315212396 Enrollment ID: I20170929002788 |
| Provider Name | Tricia S Turpen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457720757 PECOS PAC ID: 1355608837 Enrollment ID: I20171208002097 |
| Provider Name | Tynesha Guest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760846323 PECOS PAC ID: 8224370622 Enrollment ID: I20190506001241 |
| Provider Name | Michael Joseph Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740846013 PECOS PAC ID: 9739415886 Enrollment ID: I20190726000704 |
| Provider Name | Brandon M Goeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427402999 PECOS PAC ID: 0042549826 Enrollment ID: I20190903002834 |
| Provider Name | Brian Scott Landrum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902281520 PECOS PAC ID: 8527390194 Enrollment ID: I20191031000786 |
| Provider Name | Patricia Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851941363 PECOS PAC ID: 8921330226 Enrollment ID: I20191105001968 |
| Provider Name | Regina R Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720288095 PECOS PAC ID: 1850448804 Enrollment ID: I20191206002445 |
| Provider Name | Sarah M Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427408467 PECOS PAC ID: 4688007164 Enrollment ID: I20191216000093 |
| Provider Name | Isabel K Norian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831205863 PECOS PAC ID: 3072511146 Enrollment ID: I20200324001532 |
| Provider Name | Eve M Kellner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306286067 PECOS PAC ID: 7416267208 Enrollment ID: I20210219000069 |
| Provider Name | Chidinma E Isinguzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558640094 PECOS PAC ID: 6406157007 Enrollment ID: I20210304001517 |
| Provider Name | Stephanie L Myers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104041284 PECOS PAC ID: 0446667125 Enrollment ID: I20210324002202 |
| Provider Name | Jessica Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932610565 PECOS PAC ID: 3072920594 Enrollment ID: I20210330002112 |
| Provider Name | Alison R Dault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770113474 PECOS PAC ID: 9234546763 Enrollment ID: I20210330002217 |
| Provider Name | Tammy M Lafey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023592995 PECOS PAC ID: 6608283056 Enrollment ID: I20210331000761 |
| Provider Name | Jessica L Sevic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902322308 PECOS PAC ID: 4385049212 Enrollment ID: I20210816002497 |
| Provider Name | Elizabeth Morrow Derose |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265650667 PECOS PAC ID: 0143471797 Enrollment ID: I20211019002861 |
| Provider Name | Lorissa K Schrems |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871076380 PECOS PAC ID: 4385032812 Enrollment ID: I20211102001771 |
| Provider Name | Tammie Monea Richards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013683689 PECOS PAC ID: 6901298256 Enrollment ID: I20220118000989 |
| Provider Name | Amy C Stratton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124494539 PECOS PAC ID: 7618364803 Enrollment ID: I20220418000465 |
| Provider Name | Sara Vanbronkhorst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912380593 PECOS PAC ID: 1658676572 Enrollment ID: I20220727001104 |
| Provider Name | Megan E Maier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831683473 PECOS PAC ID: 9931456308 Enrollment ID: I20220803003127 |
| Provider Name | Renee Rose Augustyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033870035 PECOS PAC ID: 2264815448 Enrollment ID: I20220822000824 |
| Provider Name | Sarah Marie Dolecki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861047763 PECOS PAC ID: 4688058811 Enrollment ID: I20220907001071 |
| Provider Name | Alice Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750437794 PECOS PAC ID: 0941527832 Enrollment ID: I20230307001460 |
| Provider Name | Priscilla Harmon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588015861 PECOS PAC ID: 6608232012 Enrollment ID: I20230509002467 |
| Provider Name | Eric Fullen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477105294 PECOS PAC ID: 2264898527 Enrollment ID: I20230512000272 |
| Provider Name | Andrae T Agnew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306481023 PECOS PAC ID: 6305203704 Enrollment ID: I20230530002684 |
| Provider Name | Emily Stark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295399749 PECOS PAC ID: 0244691343 Enrollment ID: I20230807000346 |
| Provider Name | Berenese B Canady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053616292 PECOS PAC ID: 0143479642 Enrollment ID: I20230814003226 |
| Provider Name | Kristin L Meyering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497432108 PECOS PAC ID: 6406218734 Enrollment ID: I20230817002040 |
| Provider Name | Lacey Rose Burie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699417402 PECOS PAC ID: 7810351863 Enrollment ID: I20230911001308 |
| Provider Name | Alexa Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659903375 PECOS PAC ID: 4183071178 Enrollment ID: I20231113003293 |
| Provider Name | Mehgan Mcneil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649647280 PECOS PAC ID: 6204287790 Enrollment ID: I20240109003059 |
| Provider Name | Kayla Deweerd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235523747 PECOS PAC ID: 1254784150 Enrollment ID: I20240126002845 |
| Provider Name | Emina Djonko Little |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194291559 PECOS PAC ID: 6103260187 Enrollment ID: I20240217000364 |
| Provider Name | Grace Dewitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073022620 PECOS PAC ID: 4486099645 Enrollment ID: I20240227002881 |
| Provider Name | Simone Alejandra Vieco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164165189 PECOS PAC ID: 0648615849 Enrollment ID: I20240227004190 |
| Provider Name | Christopher S Moon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689124117 PECOS PAC ID: 6002252202 Enrollment ID: I20240311001563 |
| Provider Name | Jason Lee Boeve |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477828986 PECOS PAC ID: 6507202579 Enrollment ID: I20240313000305 |
| Provider Name | Renai Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790872158 PECOS PAC ID: 9830344399 Enrollment ID: I20240322000387 |
| Provider Name | Amber Elizabeth Ravikumar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154833168 PECOS PAC ID: 8123465085 Enrollment ID: I20240327001699 |
| Provider Name | Kelsea Danielle Peck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437704327 PECOS PAC ID: 4688012487 Enrollment ID: I20240328003770 |
| Provider Name | Cassidy Ann Grooms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235793563 PECOS PAC ID: 2567800394 Enrollment ID: I20240329000677 |
| Provider Name | Kaitlyn Mckenna Mckenzie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932693983 PECOS PAC ID: 6608214309 Enrollment ID: I20240401000934 |
| Provider Name | Ann Wasikowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235731902 PECOS PAC ID: 4082052659 Enrollment ID: I20240402000129 |
| Provider Name | Shelby Nicole Terpstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457831711 PECOS PAC ID: 4880032408 Enrollment ID: I20240402002279 |
| Provider Name | Brooke Lynn Aggeler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780937292 PECOS PAC ID: 1456799592 Enrollment ID: I20240409000922 |
| Provider Name | Tonisha Begay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801560529 PECOS PAC ID: 5890133755 Enrollment ID: I20240411000125 |
| Provider Name | Kelsey Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639451644 PECOS PAC ID: 9739527615 Enrollment ID: I20240411000723 |
| Provider Name | Anna Elise Denicolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962832360 PECOS PAC ID: 9830538735 Enrollment ID: I20240411001895 |
| Provider Name | Ivy Rose Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154995777 PECOS PAC ID: 5496194250 Enrollment ID: I20240412004246 |
| Provider Name | Alyse Mary Weipert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578973046 PECOS PAC ID: 0143669861 Enrollment ID: I20240415001842 |
| Provider Name | Jennifer Christina Mack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629400353 PECOS PAC ID: 9739528464 Enrollment ID: I20240415002102 |
| Provider Name | Lauren Breanne Huisman-woy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033620836 PECOS PAC ID: 3173962560 Enrollment ID: I20240418000666 |
| Provider Name | Samantha Ann Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932774718 PECOS PAC ID: 7416396718 Enrollment ID: I20240419000735 |
| Provider Name | Carla May Waite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083973135 PECOS PAC ID: 2860832052 Enrollment ID: I20240506000672 |
| Provider Name | Kelsey Lenore Treece |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972356020 PECOS PAC ID: 9739521709 Enrollment ID: I20240522000755 |
| Provider Name | Tierra Youngblood-field |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346757762 PECOS PAC ID: 6709262207 Enrollment ID: I20240524000906 |
| Provider Name | Erica Forde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871349787 PECOS PAC ID: 7214470145 Enrollment ID: I20240620002216 |
| Provider Name | Kristen Elizabeth Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285025734 PECOS PAC ID: 2668915190 Enrollment ID: I20240625001290 |
| Provider Name | Jacqueline Panton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245716778 PECOS PAC ID: 4981013034 Enrollment ID: I20240703001572 |
| Provider Name | Matthew R Monahan-reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891180063 PECOS PAC ID: 7719423441 Enrollment ID: I20240718001373 |
| Provider Name | Hammad Mohsin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205167624 PECOS PAC ID: 5092029629 Enrollment ID: I20240808002956 |
| Provider Name | Theresa Sprader |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710242722 PECOS PAC ID: 7113465030 Enrollment ID: I20240809002870 |
| Provider Name | Keturah Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245741016 PECOS PAC ID: 5092253351 Enrollment ID: I20240816003887 |
| Provider Name | Sheri Timon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578955142 PECOS PAC ID: 3779875885 Enrollment ID: I20240906003154 |
| Provider Name | Stephanie Hillebrand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619392404 PECOS PAC ID: 2163963679 Enrollment ID: I20240924004526 |
| Provider Name | Danielle Marie Friedman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295498871 PECOS PAC ID: 1052852340 Enrollment ID: I20240926002724 |
| Provider Name | Desiree A. Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851759807 PECOS PAC ID: 5092246892 Enrollment ID: I20241003003477 |
| Provider Name | Jessica Newman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447732532 PECOS PAC ID: 9436681475 Enrollment ID: I20241016001145 |
| Provider Name | Abigail Christine Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821428368 PECOS PAC ID: 3375076771 Enrollment ID: I20241023003614 |
| Provider Name | Alexis Renee Sumner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770243057 PECOS PAC ID: 7810420114 Enrollment ID: I20241024003554 |
| Provider Name | Sarah Jessip Matias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154764546 PECOS PAC ID: 3274066014 Enrollment ID: I20241031001777 |
| Provider Name | Nikole Muriithi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437692423 PECOS PAC ID: 4688108152 Enrollment ID: I20241107000526 |
| Provider Name | Kristin Farley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215317722 PECOS PAC ID: 7719411289 Enrollment ID: I20241107000720 |
| Provider Name | Allison Rosinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376936971 PECOS PAC ID: 0244765691 Enrollment ID: I20241122000943 |
| Provider Name | Scott Alan Vandyke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629707609 PECOS PAC ID: 0749715910 Enrollment ID: I20241125001926 |
| Provider Name | Tamika Houghton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902924665 PECOS PAC ID: 9537248448 Enrollment ID: I20241211000157 |
Reclaim Life Therapy Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 800 Monroe Ave Nw, Ste 300, Grand Rapids, MI 49503 Phone: 616-309-0107 Fax: 616-825-6185 | |
Bridges Counseling Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3280 E Beltline Ct Ne, Grand Rapids, MI 49525 Phone: 616-447-3404 | |
Hra Psychological Services Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2851 Charlevoix Dr Se Ste 323, Grand Rapids, MI 49546 Phone: 616-458-0692 Fax: 616-458-8129 | |
Perennial Health Services Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 E Fulton St, Suite 114, Grand Rapids, MI 49503 Phone: 616-633-7203 Fax: 616-427-3023 | |