Healthcare Provider Details

I. General information

NPI: 1205564531
Provider Name (Legal Business Name): STANGE CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2022
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 E PARIS AVE SE STE 203
GRAND RAPIDS MI
49546-2426
US

IV. Provider business mailing address

7150 ARMADALE CT NE
BELMONT MI
49306-9690
US

V. Phone/Fax

Practice location:
  • Phone: 616-816-1758
  • Fax: 616-333-7685
Mailing address:
  • Phone: 586-764-6671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. TORY SEIF
Title or Position: CLINIC DIRECTOR
Credential: PH.D.
Phone: 616-916-6680