Healthcare Provider Details

I. General information

NPI: 1154779478
Provider Name (Legal Business Name): AUBRI ELISE BATES MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. AUBRI ELISE KUIPERS

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4255 KALAMAZOO AVE SE
GRAND RAPIDS MI
49508
US

IV. Provider business mailing address

4255 KALAMAZOO AVE SE
GRAND RAPIDS MI
49508
US

V. Phone/Fax

Practice location:
  • Phone: 616-466-5222
  • Fax:
Mailing address:
  • Phone: 616-466-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: