Healthcare Provider Details

I. General information

NPI: 1780998906
Provider Name (Legal Business Name): PSYCHOLOGY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 PLAINFIELD AVE NE SUITE C
GRAND RAPIDS MI
49525-1644
US

IV. Provider business mailing address

4701 PLAINFIELD AVE NE SUITE C
GRAND RAPIDS MI
49525-1644
US

V. Phone/Fax

Practice location:
  • Phone: 616-361-3398
  • Fax: 616-361-3395
Mailing address:
  • Phone: 616-361-3398
  • Fax: 616-361-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301013608
License Number StateMI

VIII. Authorized Official

Name: DR. MY THI LIEN
Title or Position: SOLE PROPRIET/LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 616-361-3398