Healthcare Provider Details

I. General information

NPI: 1831001593
Provider Name (Legal Business Name): JARED STEPHENSON LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8136 48TH AVE
HUDSONVILLE MI
49426-8622
US

IV. Provider business mailing address

3886 VAN BUREN ST
HUDSONVILLE MI
49426-1038
US

V. Phone/Fax

Practice location:
  • Phone: 616-669-6824
  • Fax:
Mailing address:
  • Phone: 616-669-1740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6851118762
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: