Healthcare Provider Details

I. General information

NPI: 1902601487
Provider Name (Legal Business Name): JARMA WELLS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 EASTERN AVE SE UNIT 7748
GRAND RAPIDS MI
49510-5024
US

IV. Provider business mailing address

1836 SOUTHAMPTON DR SE
GRAND RAPIDS MI
49508-2649
US

V. Phone/Fax

Practice location:
  • Phone: 616-808-1097
  • Fax:
Mailing address:
  • Phone: 616-808-1097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801068327
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: