Healthcare Provider Details

I. General information

NPI: 1972428134
Provider Name (Legal Business Name): FAITH A SPEIGNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 LEONARD ST NE
GRAND RAPIDS MI
49505-5572
US

IV. Provider business mailing address

1260 WOODFIELD EAST DR SE APT 8
GRAND RAPIDS MI
49508-7825
US

V. Phone/Fax

Practice location:
  • Phone: 616-456-6571
  • Fax:
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: