Healthcare Provider Details

I. General information

NPI: 1932844834
Provider Name (Legal Business Name): DR. SHERRY STEENWYK, PH.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E BELTLINE AVE SE STE 102
GRAND RAPIDS MI
49546-7673
US

IV. Provider business mailing address

2025 E BELTLINE AVE SE STE 102
GRAND RAPIDS MI
49546-7673
US

V. Phone/Fax

Practice location:
  • Phone: 616-320-4886
  • Fax:
Mailing address:
  • Phone: 616-320-4886
  • 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. SHERRY ANN MILBRIGHT STEENWYK
Title or Position: LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 616-320-4886