Pine Rest Christian Mental Health Services in Grand Rapids - Counselor
Pine Rest Christian Mental Health Services - NPI 1124171954
Pine Rest Christian Mental Health Services is a Counselor in Grand Rapids, Michigan. Pine Rest Christian Mental Health Services practices all healthcare services and medical treatments related to Counselor. The NPI Number for Pine Rest Christian Mental Health Services is 1124171954. The last update date is 2020-11-04.
Pine Rest Christian Mental Health Services's current location address is 300 68th St Se, Grand Rapids, Michigan. You can contact this provider via phone number 6164555000. The mailing address for Pine Rest Christian Mental Health Services is 300 68th St Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pine Rest Christian Mental Health Services |
|---|---|
| Address | 300 68th St Se, Grand Rapids, Michigan |
| Phone Number | 6164555000 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGED CA |
|---|---|
| Authorized Official Name | Fennema Diane |
| Telephone Number | 6162816372 |
NPI Number Detail
| NPI Number | 1124171954 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2020-11-04 |
Provider Mailing Address Detail
| Address | 300 68th St Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495486927 |
| Phone Number | 6164555000 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
|
Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 260D17625 | MI | BCBS PSYCHIATRIST | |
| 680D16189 | MI | PSYCHOLOGISTS | |
| P10D11275 | MI | PSYCHOLOGISTS-DOCTORAL LL | |
| 110D148370 | MI | INTERNAL MEDICINE | |
| 350D148360 | MI | PEDIATRICS | |
| 500D11133 | MI | NURSE PRACTIONERS | |
| 800D16222 | MI | SOCIAL WORKERS | |
| PSYCHIATIRSTS | MI | MULTISPECIALTY |
Post Comment/ Review Below
What is the Pine Rest Christian Mental Health Services's unique identification number?
The Pine Rest Christian Mental Health Services has been assigned the NPI (National Provider Identifier) Number 1124171954 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Pine Rest Christian Mental Health Services is physically located?
The Pine Rest Christian Mental Health Services is physically situated at the following address: 300 68Th St Se, Grand Rapids, MI, 495486927.
What is Pine Rest Christian Mental Health Services's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Pine Rest Christian Mental Health Services is Counselor, and the taxonomy code that categorizes this field of expertise is 101Y00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1124171954 to Pine Rest Christian Mental Health Services?
The Centers for Medicare & Medicaid Services originally issued the 1124171954 to Pine Rest Christian Mental Health Services on 2007-01-18.
As of what date were the Pine Rest Christian Mental Health Services's details last updated?
The information pertaining to the Pine Rest Christian Mental Health Services, including its address, specialty, and other details, was most recently updated on 2020-11-04.