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NPI Code Detail

MEDICARE: ROXANA BERNIER PESANTE

MEDICARE: ROXANA BERNIER PESANTE
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 Worker6851120754MI

General Provider Information

NPI Number : 1588598809
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROXANA BERNIER PESANTE
Provider Business Mailing Address
First Line : 2335 BURTON ST SE STE 210
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49506-4669
Country : US
Telephone Number : 616-236-3600
Fax Number :
Provider Business Practice Location Address
First Line : 2335 BURTON ST SE STE 210
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49506-4669
Country : US
Telephone Number : 616-236-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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Directions to “ ROXANA BERNIER PESANTE ” Practice Location

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