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General NPI Number Information
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NPI Number | 1720798598
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Entity Type | Organization
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Legal Business Name | REFLECTIVE PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 4300 ESTATE DR
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City | HOLLAND
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State | MI
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Zip | 49424-5608
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Country | US
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Telephone | 616-330-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 2789 N CEDARIDGE DR
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City | MIDLAND
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State | MI
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Zip | 48642-8896
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ALEXA M SORENSEN
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Credential | LMSW
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Telephone | 616-330-5566
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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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