Healthcare Provider Details

I. General information

NPI: 1780536565
Provider Name (Legal Business Name): TIERNEY MOSIER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S DIVISION ST
SPRING LAKE MI
49456-2015
US

IV. Provider business mailing address

107 S DIVISION ST
SPRING LAKE MI
49456-2015
US

V. Phone/Fax

Practice location:
  • Phone: 616-581-1422
  • Fax:
Mailing address:
  • Phone: 616-581-1422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TIERNEY MOSIER
Title or Position: THERAPIST
Credential:
Phone: 616-581-1422