Healthcare Provider Details

I. General information

NPI: 1427454610
Provider Name (Legal Business Name): DANIEL L BIERMA LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 COLLEGE AVE
HOLLAND MI
49423-3644
US

IV. Provider business mailing address

328 COLLEGE AVE
HOLLAND MI
49423-3644
US

V. Phone/Fax

Practice location:
  • Phone: 616-405-5008
  • Fax:
Mailing address:
  • Phone: 616-405-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6801096697
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801096697
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number6801096697
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6801096697
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: