| Grand Rapids Center For Psychotherapy Pllc | |
|
4519 Cascade Rd Se Suite 3 Grand Rapids MI 49546-3666 | |
| (616) 949-6262 | |
| (616) 425-2003 |
| Full Name | Grand Rapids Center For Psychotherapy Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4519 Cascade Rd Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Carolyn H Carino (OWNER/PRESIDENT) |
| Authorized Official Contact | 6169496262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Rapids Center For Psychotherapy Pllc 4519 Cascade Rd Se Suite 3 Grand Rapids MI 49546-3666 Ph: (616) 949-6262 | Grand Rapids Center For Psychotherapy Pllc 4519 Cascade Rd Se Suite 3 Grand Rapids MI 49546-3666 Ph: (616) 949-6262 |
| NPI Number | 1679899280 |
|---|---|
| Provider Enumeration Date | 04/08/2010 |
| Last Update Date | 04/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679899280 | NPI | - | NPPES |
| 6801034469 | Other | MI | STATE OF MICHIGAN DEPARTMENT OF COMMUNITY HEALTH LICENSE |
| 881817049 | Other | NATIONAL ASSOCIATION OF SOCIAL WORKERS ACADEMY OF CERTIFIED SOCIAL WORKERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 680103034469 (Michigan) | Primary |
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