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NPI Code Detail

MEDICARE: IONIA COUNTY COMMUNITY MENTAL HEALTH

MEDICARE: IONIA COUNTY COMMUNITY MENTAL HEALTH
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
2251K00000XPublic Health or Welfare AgencyMI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
37509104830OTHERMIBLUE CROSS BLUE SHIELD
47509105840OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1760452122
Entity Type Code : Organization
Provider Name (Legal Business Name) : IONIA COUNTY COMMUNITY MENTAL HEALTH
Provider Business Mailing Address
First Line : 375 APPLE TREE DR
Second Line :
City : IONIA
State : MI
Zip : 48846-7506
Country : US
Telephone Number : 616-527-1790
Fax Number : 616-527-0538
Provider Business Practice Location Address
First Line : 375 APPLE TREE DR
Second Line :
City : IONIA
State : MI
Zip : 48846-7506
Country : US
Telephone Number : 616-527-1790
Fax Number : 616-527-0538
Authorized Official
Title or Position : CEO
Name : KERRY POSSEHN
Credential :
Telephone Number : 616-527-1790
Provider Enumeration Date : 01/26/2006
Last Update Date : 04/28/2025

Similar Medicare Providers

1679446215 — NICHOLAS STEVENSON
Practice Location Address:
375 APPLE TREE DR
IONIA, MI
48846-7506
Practice Phone: 616-527-1790
Practice Fax:
1386600328 — TERESA MARTIN RN
Practice Location Address:
375 APPLE TREE DR
IONIA, MI
48846-7506
Practice Phone: 616-902-2310
Practice Fax:
1205864485 — DAWN S CAMPBELL LMSW
Practice Location Address:
375 APPLE TREE DR
IONIA, MI
48846-7506
Practice Phone: 616-527-1790
Practice Fax: 616-527-0538
1447342563 — LAURIE ANN BOUSSOM LMSW
Practice Location Address:
375 APPLE TREE DR
IONIA, MI
48846-7506
Practice Phone: 616-902-4760
Practice Fax:
1801988951 — MARY LYNN BLANDING RN
Practice Location Address:
375 APPLE TREE DR
IONIA, MI
48846-7506
Practice Phone: 616-527-1790
Practice Fax: 616-527-0538
1609968775 — MELISSA DAWN JOUSMA LMSW
Practice Location Address:
375 APPLE TREE DR
IONIA, MI
48846-7506
Practice Phone: 616-527-1790
Practice Fax: 616-527-0538

Directions to “IONIA COUNTY COMMUNITY MENTAL HEALTH ” Practice Location

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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.

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