Pine Rest Christian Mental Health Services in Grand Rapids - Psychologist
Pine Rest Christian Mental Health Services - NPI 1154339521
Pine Rest Christian Mental Health Services is a Psychologist in Grand Rapids, Michigan. Pine Rest Christian Mental Health Services practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Pine Rest Christian Mental Health Services is 1154339521. 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 | 1154339521 |
|---|---|
| Provider Enumeration Date | 2006-08-03 |
| 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 | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 680D16189 | MI | PSYCHOLOGISTS | |
| P10D11275 | MI | MA, LLP/DOCTORAL | |
| 500D11133 | MI | NURSE PRACTITIONER | |
| 260D17625 | MI | PSYCHIATRIST | |
| 800D16222 | MI | SOCIAL WORKER |
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What is the Pine Rest Christian Mental Health Services's 1154339521?
The Pine Rest Christian Mental Health Services's NPI (National Provider Identifier) Number is 1154339521. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Pine Rest Christian Mental Health Services located?
The Pine Rest Christian Mental Health Services is located at 300 68Th St Se, Grand Rapids, MI 495486927.
What is Pine Rest Christian Mental Health Services's area of expertise and its corresponding taxonomy classification?
The Pine Rest Christian Mental Health Services's field of specialization is Psychologist, and it falls under the taxonomy code 103T00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1154339521 to Pine Rest Christian Mental Health Services?
The Centers for Medicare & Medicaid Services originally issued the 1154339521 to Pine Rest Christian Mental Health Services on 2006-08-03.
As of what date were the details pertaining to Pine Rest Christian Mental Health Services last refreshed?
The information related to the Pine Rest Christian Mental Health Services, including its address, specialty, and other relevant details, was last updated on 2020-11-04.
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