Healthcare Provider Details

I. General information

NPI: 1306050596
Provider Name (Legal Business Name): ENCOMPASS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4829 E. BELTLINE NE BLDG #1
GRAND RAPIDS MI
49525
US

IV. Provider business mailing address

4829 E. BELTLINE NE BLDG #1
GRAND RAPIDS MI
49525
US

V. Phone/Fax

Practice location:
  • Phone: 800-788-8630
  • Fax: 616-459-9181
Mailing address:
  • Phone: 616-459-9180
  • Fax: 616-459-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801064268
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. ALISON A. BROWN
Title or Position: CEOOWNER
Credential: PHD
Phone: 616-459-9180