Healthcare Provider Details

I. General information

NPI: 1154255586
Provider Name (Legal Business Name): LVS CLINICAL PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4467 CASCADE RD SE STE 4469
GRAND RAPIDS MI
49546-3776
US

IV. Provider business mailing address

4467 CASCADE RD SE STE 4469
GRAND RAPIDS MI
49546-3776
US

V. Phone/Fax

Practice location:
  • Phone: 517-795-7190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LISA VROMAN STOKES
Title or Position: OWNER / PSYCHOLOGIST
Credential: PHD
Phone: 517-795-7190