Healthcare Provider Details

I. General information

NPI: 1891904140
Provider Name (Legal Business Name): ROBERT DAVID LEHMAN PH.D., LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E BELTLINE AVE NE
GRAND RAPIDS MI
49525-5803
US

IV. Provider business mailing address

6300 COPPER VALLEY CT NE
ADA MI
49301-8707
US

V. Phone/Fax

Practice location:
  • Phone: 616-222-1552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401006483
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: