Healthcare Provider Details

I. General information

NPI: 1538803432
Provider Name (Legal Business Name): ERIN SUMI HENDRIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E BELTLINE AVE NE STE 300
GRAND RAPIDS MI
49506-1267
US

IV. Provider business mailing address

14945 CHANDLER RD
BATH MI
48808-9755
US

V. Phone/Fax

Practice location:
  • Phone: 616-577-7365
  • Fax: 616-841-9871
Mailing address:
  • Phone: 434-249-9795
  • Fax: 616-841-9871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301517244
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: