Healthcare Provider Details

I. General information

NPI: 1316822299
Provider Name (Legal Business Name): BRITTANY KLEMISH LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 CASCADE WEST PKWY SE
GRAND RAPIDS MI
49546-2137
US

IV. Provider business mailing address

5821 BIRDSONG CT SE
KENTWOOD MI
49508-2323
US

V. Phone/Fax

Practice location:
  • Phone: 616-930-4123
  • Fax:
Mailing address:
  • Phone: 616-881-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851117926
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: