DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WEDGWOOD CHRISTAIN SERVICES

MEDICARE: WEDGWOOD CHRISTAIN SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100594OTHERMIADDICTION COUNSELOR
26401008579OTHERMIPROFESSIONAL COUNSELOR

General Provider Information

NPI Number : 1750414827
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEDGWOOD CHRISTAIN SERVICES
Provider Business Mailing Address
First Line : 8117 CRESTVIEW AVE
Second Line :
City : JENISON
State : MI
Zip : 49428-9124
Country : US
Telephone Number : 616-706-0204
Fax Number :
Provider Business Practice Location Address
First Line : 3300 36TH ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49512-2810
Country : US
Telephone Number : 616-559-5835
Fax Number : 616-281-6448
Authorized Official
Title or Position : THERAPIST
Name : MR. ROBERT GERARD JOHNSON SR.
Credential : LPC
Telephone Number : 616-559-5835
Provider Enumeration Date : 03/14/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1205769023 — KATRINA ANN WHITE BSW
Practice Location Address:
3300 36TH ST SE
GRAND RAPIDS, MI
49512-2810
Practice Phone: 616-942-2110
Practice Fax:
1649218041 — MARION OAKES-HUNTER LLPC, CADC
Practice Location Address:
3300 36TH ST SE
GRAND RAPIDS, MI
49512-2810
Practice Phone: 616-942-2110
Practice Fax:
1215047667 — WEDGWOOD CHRISTIAN SERVICES
Practice Location Address:
3300 36TH ST SE
GRAND RAPIDS, MI
49512-2810
Practice Phone: 616-942-2110
Practice Fax: 616-942-0589
1902997224 — WEDGWOOD CHRISTIAN SERVICES
Practice Location Address:
3300 36TH ST SE
GRAND RAPIDS, MI
49512-2810
Practice Phone: 616-942-2110
Practice Fax: 616-942-0589
1386842516 — MRS. JANELL ELAINE PRINS LLMSW
Practice Location Address:
3300 36TH ST SE
GRAND RAPIDS, MI
49512-2810
Practice Phone: 616-559-5878
Practice Fax:
1396939054 — DR. ELIZABETH RAESE PSY.D.
Practice Location Address:
3300 36TH ST SE
GRAND RAPIDS, MI
49512-2810
Practice Phone: 616-831-5649
Practice Fax: 616-942-9548

Directions to “WEDGWOOD CHRISTAIN SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.