Healthcare Provider Details

I. General information

NPI: 1861337487
Provider Name (Legal Business Name): MORGAN HAMSTRA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 BALL AVE NE BLDG A
GRAND RAPIDS MI
49505-5904
US

IV. Provider business mailing address

1107 FRANKLIN AVE
GRAND HAVEN MI
49417-1641
US

V. Phone/Fax

Practice location:
  • Phone: 616-308-1978
  • Fax:
Mailing address:
  • Phone: 616-690-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: