Healthcare Provider Details

I. General information

NPI: 1700215936
Provider Name (Legal Business Name): RACHEL MARIE SWEET LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL MARIE FLETCHER LMSW

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 LAKE DR SE STE 4
GRAND RAPIDS MI
49506-1673
US

IV. Provider business mailing address

206 HODENPYL RD SE
GRAND RAPIDS MI
49506-2060
US

V. Phone/Fax

Practice location:
  • Phone: 517-214-1534
  • Fax:
Mailing address:
  • Phone: 517-214-1534
  • Fax: 517-548-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092578
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: