Healthcare Provider Details

I. General information

NPI: 1154067601
Provider Name (Legal Business Name): SHARI TEEPLE BOWERS LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2422 BURTON ST SE STE B
GRAND RAPIDS MI
49546-4810
US

IV. Provider business mailing address

2422 BURTON ST SE STE B
GRAND RAPIDS MI
49546-4810
US

V. Phone/Fax

Practice location:
  • Phone: 616-226-6522
  • Fax: 616-608-6751
Mailing address:
  • Phone: 616-226-6522
  • Fax: 616-608-6751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801115970
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: