Healthcare Provider Details

I. General information

NPI: 1285203661
Provider Name (Legal Business Name): SHERI RODRIGUEZ & ASSOCIATES THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 LANCASHIRE DR SE
GRAND RAPIDS MI
49508-2534
US

IV. Provider business mailing address

1515 LANCASHIRE DR SE
GRAND RAPIDS MI
49508-2534
US

V. Phone/Fax

Practice location:
  • Phone: 616-260-3559
  • Fax:
Mailing address:
  • Phone: 616-260-3559
  • 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: SHERI DEE RODRIGUEZ
Title or Position: OWNER/THERAPIST
Credential: LMSW
Phone: 616-260-3559