Pine Rest Christian Mental Health Services in Grand Rapids - Psychologist
Pine Rest Christian Mental Health Services - NPI 1750399309
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 1750399309. 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 | 1750399309 |
|---|---|
| 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 |
|
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 |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 260D17625 | MI | PSYCHIATRISTS | |
| 680D16189 | MI | PSYCHOLOGITS | |
| P10D11275 | MI | MA, LLP/DOCTORAL | |
| 800D16222 | MI | SOCIAL WORKER |
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What is the unique 10-digit identifier code issued to Pine Rest Christian Mental Health Services by the Centers for Medicare & Medicaid Services?
The Pine Rest Christian Mental Health Services has been assigned the NPI (National Provider Identifier) 1750399309 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Pine Rest Christian Mental Health Services?
The Pine Rest Christian Mental Health Services is physically situated at 300 68Th St Se, in the city of Grand Rapids, state of MI, with the postal code 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.
When was the Pine Rest Christian Mental Health Services's 1750399309 issued?
The Pine Rest Christian Mental Health Services's 1750399309 was issued 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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