| Building Blocks Therapy Services, Llc | |
|
600 3 Mile Rd Nw Ste 102 Grand Rapids MI 49544-1685 | |
| (616) 666-6396 | |
| (616) 259-4207 |
| Full Name | Building Blocks Therapy Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 3 Mile Rd Nw Ste 102, Grand Rapids, Michigan |
| Authorized Official Name and Position | Courtney Joesel (SPEECH AND LANGUAGE PATHOLOGIST) |
| Authorized Official Contact | 6166666396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Building Blocks Therapy Services, Llc 600 3 Mile Rd Nw Ste 102 Grand Rapids MI 49544-1685 Ph: (616) 666-6396 | Building Blocks Therapy Services, Llc 600 3 Mile Rd Nw Ste 102 Grand Rapids MI 49544-1685 Ph: (616) 666-6396 |
| NPI Number | 1356816805 |
|---|---|
| Provider Enumeration Date | 10/11/2018 |
| Last Update Date | 10/11/2018 |
| Medicare PECOS PAC ID | 3375885023 |
|---|---|
| Medicare Enrollment ID | O20190429001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356816805 | NPI | - | NPPES |
| 1639584188 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Courtney Sue Joesel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1639584188 PECOS PAC ID: 8022234632 Enrollment ID: I20140716002273 |
| Provider Name | Grace Alexandra Eisma |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1558098913 PECOS PAC ID: 9032593736 Enrollment ID: I20220830001670 |
| Provider Name | Allison Veltkamp |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1598324352 PECOS PAC ID: 2668882622 Enrollment ID: I20220927002082 |
| Provider Name | Maria Fenicle |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1336851211 PECOS PAC ID: 4385014950 Enrollment ID: I20221227000101 |
| Provider Name | Lauryn Joy Waterson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427669662 PECOS PAC ID: 2365806551 Enrollment ID: I20230906002443 |
| Provider Name | Sarah Joy Kidder |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871369157 PECOS PAC ID: 0345699591 Enrollment ID: I20231213000754 |
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