Healthcare Provider Details

I. General information

NPI: 1346139771
Provider Name (Legal Business Name): ALBYAN THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5618 E FALLING LEAF DR SE
GRAND RAPIDS MI
49512-9480
US

IV. Provider business mailing address

5618 E FALLING LEAF DR SE
GRAND RAPIDS MI
49512-9480
US

V. Phone/Fax

Practice location:
  • Phone: 616-510-5115
  • Fax:
Mailing address:
  • Phone: 616-510-5115
  • 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: RACHEL BLAIR GRIGORYAN
Title or Position: OWNER
Credential: LMSW
Phone: 616-510-5115