Healthcare Provider Details

I. General information

NPI: 1942946926
Provider Name (Legal Business Name): EMILY GRACE HAWLEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 3 MILE RD NW STE G
GRAND RAPIDS MI
49544-8209
US

IV. Provider business mailing address

640 3 MILE RD NW
GRAND RAPIDS MI
49544-8209
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-9252
  • Fax:
Mailing address:
  • Phone: 269-589-9486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801118944
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851114553
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: