| Network 180 | |
|
790 Fuller Ave Ne Grand Rapids MI 49503-1918 | |
| (616) 336-3909 | |
| (616) 336-8830 |
| Full Name | Network 180 |
|---|---|
| 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 |
|---|---|
| Network 180 790 Fuller Ave Ne Grand Rapids MI 49503-1918 Ph: (616) 336-3909 | Network 180 790 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 | () | Primary |
| Provider Name | Robert D Holwerda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205995735 PECOS PAC ID: 7416860762 Enrollment ID: I20031112000025 |
| Provider Name | Sheng an Yang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275669608 PECOS PAC ID: 1153215991 Enrollment ID: I20040211001127 |
| 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 | Donna M Kuiper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083775829 PECOS PAC ID: 4789789371 Enrollment ID: I20070410000135 |
| Provider Name | Mazhar Munir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821083924 PECOS PAC ID: 4789789744 Enrollment ID: I20070419000357 |
| Provider Name | Amy L Boshoven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336135557 PECOS PAC ID: 5991882318 Enrollment ID: I20080410000072 |
| Provider Name | Jack a Mahdasian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841246634 PECOS PAC ID: 0840185070 Enrollment ID: I20080515000530 |
| Provider Name | Jillaine Ruppel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780816520 PECOS PAC ID: 9931255106 Enrollment ID: I20090914000607 |
| Provider Name | Adrianne L Prentiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366676421 PECOS PAC ID: 4082743265 Enrollment ID: I20100526000661 |
| Provider Name | Timothy G Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194056457 PECOS PAC ID: 9436289915 Enrollment ID: I20100609000749 |
| 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 | Marvin Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932221876 PECOS PAC ID: 8820286644 Enrollment ID: I20101221000642 |
| Provider Name | Donald G Weston |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992784722 PECOS PAC ID: 0749478014 Enrollment ID: I20101230000809 |
| Provider Name | Robert S La Fleur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043260177 PECOS PAC ID: 8224219522 Enrollment ID: I20110218000995 |
| Provider Name | Shannon M Mullett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093018145 PECOS PAC ID: 7911180286 Enrollment ID: I20110323000770 |
| 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 | Karla S Verhage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952603276 PECOS PAC ID: 1153584859 Enrollment ID: I20120516000363 |
| 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 | Sherita Joshway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225338957 PECOS PAC ID: 2062667173 Enrollment ID: I20130221000073 |
| Provider Name | Joel M Sanchez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104147511 PECOS PAC ID: 0547415424 Enrollment ID: I20130226000144 |
| 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 | Kahana Delore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083059802 PECOS PAC ID: 5991026924 Enrollment ID: I20150603000642 |
| Provider Name | Mary Linnea Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932460912 PECOS PAC ID: 6709186844 Enrollment ID: I20151123000817 |
| Provider Name | Constance D Demorest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427308923 PECOS PAC ID: 1153623822 Enrollment ID: I20160112002772 |
| Provider Name | Anthony a Matson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215227129 PECOS PAC ID: 6901196328 Enrollment ID: I20160526000251 |
| Provider Name | Jean Christiana Marion Talsma |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1144660200 PECOS PAC ID: 0840583639 Enrollment ID: I20160802000442 |
| Provider Name | Jessica Warner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649673591 PECOS PAC ID: 5193005650 Enrollment ID: I20161130000039 |
| Provider Name | Emily Jane-taylor Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568855633 PECOS PAC ID: 7618257171 Enrollment ID: I20161130000100 |
| Provider Name | Jill Rountree |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396291977 PECOS PAC ID: 7214210822 Enrollment ID: I20170206001495 |
| 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 | Denise Marie Skonieczny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528404761 PECOS PAC ID: 5597023317 Enrollment ID: I20171227000556 |
| Provider Name | Nguyet-nhi Alaina Radics |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750796637 PECOS PAC ID: 4385904168 Enrollment ID: I20180216001523 |
| Provider Name | Jordan K Swan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790207272 PECOS PAC ID: 7618202516 Enrollment ID: I20190715003356 |
| Provider Name | Alison Schuyler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427564988 PECOS PAC ID: 6901134584 Enrollment ID: I20190820003219 |
| Provider Name | Patricia Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851941363 PECOS PAC ID: 8921330226 Enrollment ID: I20191105001968 |
| 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 | Candace J Yeager |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427692078 PECOS PAC ID: 5395162127 Enrollment ID: I20200825002832 |
| 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 | 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 | Sidney Dykstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467075218 PECOS PAC ID: 0244601037 Enrollment ID: I20230112002739 |
| Provider Name | Brina Tiemeyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932602760 PECOS PAC ID: 2668837196 Enrollment ID: I20230504003154 |
| 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 | Kala Pozivilko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669042990 PECOS PAC ID: 0345638052 Enrollment ID: I20230712003074 |
| 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 | Melanie a Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043730153 PECOS PAC ID: 3173893484 Enrollment ID: I20230913001739 |
| Provider Name | Grant Buhr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497222608 PECOS PAC ID: 8426412891 Enrollment ID: I20230919000922 |
| Provider Name | Michelle M Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063898658 PECOS PAC ID: 9739536319 Enrollment ID: I20231104000175 |
| Provider Name | Alexa Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659903375 PECOS PAC ID: 4183071178 Enrollment ID: I20231113003293 |
| Provider Name | Nicholas Bayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295206936 PECOS PAC ID: 8628427994 Enrollment ID: I20231212001718 |
| 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 | Valerie Anne Laster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174950877 PECOS PAC ID: 5294171617 Enrollment ID: I20240307003372 |
| 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 | Charles Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295015428 PECOS PAC ID: 4385009968 Enrollment ID: I20240319002581 |
| 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 | Kaitlyn Mckenna Mckenzie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932693983 PECOS PAC ID: 6608214309 Enrollment ID: I20240401000934 |
| Provider Name | Ann Brady |
|---|---|
| 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 | Brett Romanowski-pfeiffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346803020 PECOS PAC ID: 2668811548 Enrollment ID: I20240412000367 |
| 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 | Dennis Dowling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831582576 PECOS PAC ID: 1557701646 Enrollment ID: I20240507001533 |
| 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 | Rissa Hasina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851047229 PECOS PAC ID: 9335681709 Enrollment ID: I20240613000683 |
| Provider Name | Breanna Christine Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912567868 PECOS PAC ID: 2466995436 Enrollment ID: I20240618003306 |
| 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 | Lisa Watson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962826958 PECOS PAC ID: 1557808086 Enrollment ID: I20240801004004 |
| Provider Name | Hammad Mohsin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205167624 PECOS PAC ID: 5092029629 Enrollment ID: I20240808002956 |
| Provider Name | Keturah Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245741016 PECOS PAC ID: 5092253351 Enrollment ID: I20240816003887 |
| Provider Name | Asha Upakrwoth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689228314 PECOS PAC ID: 6103367768 Enrollment ID: I20240923002132 |
| Provider Name | Danielle Marie Eason |
|---|---|
| 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 | Alexis Renee Sumner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770243057 PECOS PAC ID: 7810420114 Enrollment ID: I20241024003554 |
| Provider Name | Gabriel Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114545423 PECOS PAC ID: 8921531575 Enrollment ID: I20241104002966 |
| Provider Name | Giovanni Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669096046 PECOS PAC ID: 1254866312 Enrollment ID: I20241126001872 |
| Provider Name | Nichole Adeline Chaput |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346834579 PECOS PAC ID: 9032645320 Enrollment ID: I20241210002894 |
| Provider Name | Tamika Houghton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902924665 PECOS PAC ID: 9537248448 Enrollment ID: I20241211000157 |
| Provider Name | Emily Nykamp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689232233 PECOS PAC ID: 2264968320 Enrollment ID: I20241212001161 |
| Provider Name | Rupinder Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396187514 PECOS PAC ID: 8325575996 Enrollment ID: I20241219003882 |
| Provider Name | Bobbi Faasen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578316402 PECOS PAC ID: 2567999162 Enrollment ID: I20241220000633 |
| Provider Name | Kimber G Decker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144759655 PECOS PAC ID: 4284161613 Enrollment ID: I20241226001504 |
| Provider Name | Diana Duarte-menendez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003490111 PECOS PAC ID: 5890222889 Enrollment ID: I20250103000490 |
| Provider Name | Erin Catherine Gorman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689068165 PECOS PAC ID: 5991233082 Enrollment ID: I20250117001039 |
| Provider Name | Domonique Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972060895 PECOS PAC ID: 1254860349 Enrollment ID: I20250117001050 |
| Provider Name | Jennifer Nicole Ausbrooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922619063 PECOS PAC ID: 2365972486 Enrollment ID: I20250205000270 |
| Provider Name | Suzanne Kibby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447641360 PECOS PAC ID: 1153843818 Enrollment ID: I20250321003155 |
| Provider Name | Emily Grochowalski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326667635 PECOS PAC ID: 1254856461 Enrollment ID: I20250421002198 |
| Provider Name | Sean Hawkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659802585 PECOS PAC ID: 0941572234 Enrollment ID: I20250612002735 |
| Provider Name | Ashley Nichole Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700439502 PECOS PAC ID: 5193238277 Enrollment ID: I20250701003919 |
| Provider Name | Lisa Marie Alfriend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912278433 PECOS PAC ID: 2567978919 Enrollment ID: I20250722003232 |
| Provider Name | Abigail Breese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801784640 PECOS PAC ID: 8123529534 Enrollment ID: I20250828001116 |
| Provider Name | Stephanie Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679222574 PECOS PAC ID: 7517468945 Enrollment ID: I20250828001832 |
| Provider Name | Katherine E Kunnen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003342551 PECOS PAC ID: 7911408034 Enrollment ID: I20250829003453 |
| Provider Name | Ebony Angelique Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285277954 PECOS PAC ID: 2163924630 Enrollment ID: I20250904002013 |
| Provider Name | Laura Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598156515 PECOS PAC ID: 0648773127 Enrollment ID: I20250911000988 |
| Provider Name | Robin Nicole Zody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740152768 PECOS PAC ID: 8729584354 Enrollment ID: I20251002002856 |
| Provider Name | Naga Prasuna Vanipenta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164885943 PECOS PAC ID: 1153613922 Enrollment ID: I20251006001432 |
| Provider Name | Laura Oesch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205473931 PECOS PAC ID: 1557858669 Enrollment ID: I20251014000541 |
| Provider Name | Mercedes Noble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902258718 PECOS PAC ID: 5799272373 Enrollment ID: I20251016002741 |
| Provider Name | Lenair Marie Correll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518325604 PECOS PAC ID: 5193213916 Enrollment ID: I20251023001922 |
| Provider Name | Andrea Darlene Koski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891325577 PECOS PAC ID: 1052809761 Enrollment ID: I20251023004405 |
| Provider Name | Sarah E.W. Koon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811249691 PECOS PAC ID: 8224526819 Enrollment ID: I20251024001504 |
| Provider Name | Debra Jesudowich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174211791 PECOS PAC ID: 2961991419 Enrollment ID: I20251027001972 |
| Provider Name | Jillaine Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811712755 PECOS PAC ID: 3971092024 Enrollment ID: I20251029001085 |
| Provider Name | Benjamin Robert Aparicio-farina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104494178 PECOS PAC ID: 4880183946 Enrollment ID: I20251029001436 |
| Provider Name | Elizabeth Dinkel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881064228 PECOS PAC ID: 4981194461 Enrollment ID: I20251104000702 |
| Provider Name | Laura Leigh Chapton-hunt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235566316 PECOS PAC ID: 2163851114 Enrollment ID: I20251119002304 |
| Provider Name | Nora Mei Luchs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821575689 PECOS PAC ID: 8426540899 Enrollment ID: I20251124000242 |
| Provider Name | Stephanie Dodde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679965594 PECOS PAC ID: 1456843432 Enrollment ID: I20251126001236 |
| Provider Name | Logan Saidla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710408380 PECOS PAC ID: 9133613193 Enrollment ID: I20251209000232 |
| Provider Name | Benjamin Brower |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841558053 PECOS PAC ID: 9931573870 Enrollment ID: I20251210001904 |
| Provider Name | Shaunna Dior Abuya |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275034506 PECOS PAC ID: 6901392083 Enrollment ID: I20251227000332 |
| Provider Name | Jenifer Joy Vanwyngarden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912270349 PECOS PAC ID: 1658867635 Enrollment ID: I20251229002974 |
| Provider Name | Hope Lunde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417528803 PECOS PAC ID: 7214423060 Enrollment ID: I20251231000902 |
| Provider Name | Corinthia Hoff Pinks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851138713 PECOS PAC ID: 2264928688 Enrollment ID: I20260106000362 |
| Provider Name | Hillary Uldricks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699550558 PECOS PAC ID: 0143707406 Enrollment ID: I20260117000312 |
| Provider Name | Anna Geurkink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033774807 PECOS PAC ID: 1456838648 Enrollment ID: I20260120000457 |
| Provider Name | Velessaunia Bridges-wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649501503 PECOS PAC ID: 1951889179 Enrollment ID: I20260129002677 |
| Provider Name | Joann Crumm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295127918 PECOS PAC ID: 8628556743 Enrollment ID: I20260130001281 |
| Provider Name | Jeffrey Daniel Marsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598114936 PECOS PAC ID: 2860970902 Enrollment ID: I20260130001842 |
| Provider Name | Andrew Asdell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255723052 PECOS PAC ID: 2860801362 Enrollment ID: I20260131000169 |
| Provider Name | John Leroy Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023513124 PECOS PAC ID: 1850870312 Enrollment ID: I20260205002390 |
| Provider Name | Emily Strating |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831878784 PECOS PAC ID: 1951881713 Enrollment ID: I20260219001511 |
| Provider Name | Keyshara Monae Hudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225838253 PECOS PAC ID: 9436630852 Enrollment ID: I20260224003525 |
| Provider Name | Antoinette Alexandria Vargas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750034559 PECOS PAC ID: 5496236754 Enrollment ID: I20260225000377 |
| Provider Name | Stephanie Doyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770244931 PECOS PAC ID: 8123509130 Enrollment ID: I20260226002872 |
| Provider Name | Rachel Love |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831823053 PECOS PAC ID: 8426530486 Enrollment ID: I20260307000059 |
| Provider Name | Angela Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326434093 PECOS PAC ID: 5799250858 Enrollment ID: I20260407001793 |
| Provider Name | Bethany Stacey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497444624 PECOS PAC ID: 1951876663 Enrollment ID: I20260410000458 |
| Provider Name | Kathleen Bloom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952794950 PECOS PAC ID: 8325516834 Enrollment ID: I20260504005579 |
| Provider Name | Shannon Przygocki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548857410 PECOS PAC ID: 1951873934 Enrollment ID: I20260611000778 |
Reclaim Life Therapy PLLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 800 Monroe Ave Nw Ste 308, Grand Rapids, MI 49503 Phone: 616-309-0107 Fax: 616-825-6185 |
Bridges Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3280 E Beltline Ct Ne, Grand Rapids, MI 49525 Phone: 616-447-3404 |
Tru Behavior Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 941 Joslin St Se, Grand Rapids, MI 49507 Phone: 616-287-0740 |
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 |
Heart of the City Health Center West Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Sheldon Blvd Se, Grand Rapids, MI 49503 Phone: 616-965-8282 Fax: 616-940-5366 |