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General NPI Number Information
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NPI Number | 1629969068
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Entity Type | Organization
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Legal Business Name | VAN BUREN COMMUNITY MENTAL HEALTH AUTHORITY
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 801 HAZEN ST STE C
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City | PAW PAW
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State | MI
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Zip | 49079-2008
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Country | US
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Telephone | 269-657-5574
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Fax |
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Provider Business Mailing Address
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Address Line | 801 HAZEN ST STE C
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City | PAW PAW
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State | MI
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Zip | 49079-2008
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Country | US
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Telephone | 269-657-5574
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEBRA HESS
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Credential |
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Telephone | 269-655-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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