Healthcare Provider Details

I. General information

NPI: 1619746195
Provider Name (Legal Business Name): MRS. DESIREE PARTIDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE GONZALEZ

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 CASCADE RD SE STE 3
GRAND RAPIDS MI
49546-8384
US

IV. Provider business mailing address

756 FULTON ST W STE 201
GRAND RAPIDS MI
49504-6406
US

V. Phone/Fax

Practice location:
  • Phone: 877-654-4144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451025438
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: