Healthcare Provider Details

I. General information

NPI: 1255249884
Provider Name (Legal Business Name): STEPHANIE RANN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 E BELTLINE AVE NE STE 100
GRAND RAPIDS MI
49506-1214
US

IV. Provider business mailing address

360 E BELTLINE AVE NE STE 100
GRAND RAPIDS MI
49506-1214
US

V. Phone/Fax

Practice location:
  • Phone: 616-805-3660
  • Fax: 616-805-3631
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: