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General NPI Number Information
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NPI Number | 1912278433
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Entity Type | Individual
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Provider Name | LISA MARIE ALFRIEND
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Gender | Female
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 260 JEFFERSON AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4597
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Country | US
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Telephone | 616-336-3909
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Fax | 616-336-8830
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Provider Business Mailing Address
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Address Line | DEPT 781625
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City | DETROIT
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State | MI
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Zip | 48278-1625
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Country | US
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Telephone | 614-355-8004
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Fax | 614-355-2220
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | I1700506
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License Number State | OH
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