Healthcare Provider Details

I. General information

NPI: 1932013273
Provider Name (Legal Business Name): MICHAEL ALLEN JR. LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

4270 PLAINFIELD AVE NE
GRAND RAPIDS MI
49525-1603
US

IV. Provider business mailing address

1323 MAPLEROW AVE NW
GRAND RAPIDS MI
49534-2267
US

V. Phone/Fax

Practice location:
  • Phone: 616-965-1229
  • Fax:
Mailing address:
  • Phone: 616-965-1229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121823
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: