Healthcare Provider Details
I. General information
NPI: 1225336175
Provider Name (Legal Business Name): WELL BEING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2011
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
540 LEONARD ST NW STE G
GRAND RAPIDS MI
49504-4260
US
IV. Provider business mailing address
540 LEONARD ST NW STE G
GRAND RAPIDS MI
49504-4260
US
V. Phone/Fax
- Phone: 616-458-6870
- Fax: 616-458-6874
- Phone: 616-458-6870
- Fax: 616-458-6874
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIMOTHY
J
PIERI
Title or Position: PARTNER
Credential: LMSW
Phone: 616-458-6870