Healthcare Provider Details

I. General information

NPI: 1689963993
Provider Name (Legal Business Name): SAMANTHA LEIGH AKERMAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5270 NORTHLAND DR NE STE 2B
GRAND RAPIDS MI
49525-1073
US

IV. Provider business mailing address

8340 14 MILE RD NE
CEDAR SPRINGS MI
49319-9527
US

V. Phone/Fax

Practice location:
  • Phone: 616-951-1277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801091661
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801091661
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: