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NPI Code Detail

MEDICARE: MARLISE B VAN ZYTVELD LMSW

MEDICARE:   MARLISE B VAN ZYTVELD  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801061310MI

General Provider Information

NPI Number : 1235152471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLISE B VAN ZYTVELD LMSW
Provider Business Mailing Address
First Line : 333 BRIDGE ST NW STE 1120
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-5356
Country : US
Telephone Number : 616-805-3660
Fax Number : 616-805-3631
Provider Business Practice Location Address
First Line : 3800 LAKE MICHIGAN DR NW STE 103
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49534-4583
Country : US
Telephone Number : 616-805-3660
Fax Number : 616-805-3631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 03/15/2023

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Directions to “ MARLISE B VAN ZYTVELD LMSW” Practice Location

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