Healthcare Provider Details

I. General information

NPI: 1073658597
Provider Name (Legal Business Name): COMPREHENSIVE THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 ARDMORE ST SE
GRAND RAPIDS MI
49506-4924
US

IV. Provider business mailing address

2505 ARDMORE ST SE
GRAND RAPIDS MI
49506-4924
US

V. Phone/Fax

Practice location:
  • Phone: 616-559-1054
  • Fax: 616-559-1056
Mailing address:
  • Phone: 616-559-1054
  • Fax: 616-559-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301002435
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201006103
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101000658
License Number StateMI
# 6
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number766216
License Number StateMI

VIII. Authorized Official

Name: ELLEN SAWYER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 616-559-1054