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General NPI Number Information
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NPI Number | 1841840220
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Entity Type | Organization
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Legal Business Name | BRAINSTIM LLC
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 847 PARCHMENT DR SE STE 120
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2377
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Country | US
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Telephone | 616-913-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 847 PARCHMENT DR SE STE 120
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2377
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Country | US
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Telephone | 616-913-8441
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | CHRISTOPHER SHEPARD
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Credential |
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Telephone | 248-613-9584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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