Healthcare Provider Details

I. General information

NPI: 1497808117
Provider Name (Legal Business Name): JANE LYNNE STOCKINGER LMSW ACSW BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANE LYNNETTE SEAR FOSS

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 KRAFT AVE SE SUITE 272
GRAND RAPIDS MI
49512-2076
US

IV. Provider business mailing address

2828 KRAFT AVE SE SUITE 272
GRAND RAPIDS MI
49512-2076
US

V. Phone/Fax

Practice location:
  • Phone: 616-940-9090
  • Fax: 616-940-9089
Mailing address:
  • Phone: 616-940-9090
  • Fax: 616-940-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801080952
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704077527
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: