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General NPI Number Information
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NPI Number | 1215800990
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Entity Type | Organization
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Legal Business Name | CONNECTED DEVELOPMENT THERAPEUTIC & TRAINING SERVICES, PLLC
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Dates
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Enumeration Date | 09/27/2025
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 7499 SILVER RIDGE DR NE
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City | ROCKFORD
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State | MI
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Zip | 49341-8692
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Country | US
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Telephone | 616-594-0554
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Fax |
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Provider Business Mailing Address
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Address Line | 7499 SILVER RIDGE DR NE
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City | ROCKFORD
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State | MI
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Zip | 49341-8692
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Country | US
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Telephone | 616-594-0554
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR/CLINICIAN
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Name | DR. STEPHANIE LEA GRANT
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Credential | MA, PHD, LPC, IMH-E
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Telephone | 616-594-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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