Healthcare Provider Details

I. General information

NPI: 1396605069
Provider Name (Legal Business Name): SARAH PATTISON LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS MI
49546-5700
US

IV. Provider business mailing address

3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS MI
49546-5700
US

V. Phone/Fax

Practice location:
  • Phone: 616-425-2412
  • Fax: 616-828-4229
Mailing address:
  • Phone: 616-425-2412
  • Fax: 616-828-4229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851120658
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: