Healthcare Provider Details

I. General information

NPI: 1174458491
Provider Name (Legal Business Name): LINDSAY MARIE VANDYKE LLMFT, LLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17224 VAN WAGONER RD
SPRING LAKE MI
49456-9702
US

IV. Provider business mailing address

10039 PRAIRIE GRASS CT
ZEELAND MI
49464-8318
US

V. Phone/Fax

Practice location:
  • Phone: 616-296-2130
  • Fax:
Mailing address:
  • Phone: 616-610-9281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4151001192
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: