Healthcare Provider Details

I. General information

NPI: 1720801442
Provider Name (Legal Business Name): HANNAH BYLSMA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH LANKHEET PSYD

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SHELDON AVE SE STE 202
GRAND RAPIDS MI
49503-4224
US

IV. Provider business mailing address

75 SHELDON AVE SE STE 202
GRAND RAPIDS MI
49503-4224
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-3398
  • Fax:
Mailing address:
  • Phone: 616-391-3398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019572
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: