Healthcare Provider Details

I. General information

NPI: 1790697290
Provider Name (Legal Business Name): JOEL DAVID GLOVER MSW, LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 E 24TH ST
HOLLAND MI
49423-4880
US

IV. Provider business mailing address

2905 BROOKWIND DR
HOLLAND MI
49424-1684
US

V. Phone/Fax

Practice location:
  • Phone: 616-494-2432
  • Fax:
Mailing address:
  • Phone: 616-494-2432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801064846
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: