Healthcare Provider Details

I. General information

NPI: 1295854842
Provider Name (Legal Business Name): KAREN B FOLEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN BUGG

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 CHERRY ST SE STE 203
GRAND RAPIDS MI
49503-4608
US

IV. Provider business mailing address

1900 44TH ST SE
KENTWOOD MI
49508-5008
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-5050
  • Fax:
Mailing address:
  • Phone: 616-685-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801085663
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704220914
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28074654A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801085663
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: