CHERRY STREET SERVICES INC NPI 1184974263

NPI Information

  • NPI: 1184974263
  • Provider Name: CHERRY STREET SERVICES INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: WYOMING COMMUNITY HEALTH CENTER
  • CLIA Number: 23D2047786
  • Address: 2929 BURLINGAME AVE SW
    WYOMING, MI
    ZIP 49509
  • Phone: (616) 965-8333

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NPI Details

CHERRY STREET SERVICES INC is a federally qualified health center (fqhc) clinic center in Wyoming, MI. CHERRY STREET SERVICES INC NPI is 1184974263. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wyoming Community Health Center.

The provider's business location address is:

2929 BURLINGAME AVE SW
WYOMING, MI
ZIP 49509-609
Phone: (616) 965-8333
Fax: (616) 940-5820

The provider's authorized official is Tasha Blackmon .
The authorized official title is Ceo and has the following contact phone number (616) 965-8200.

The CLIA number assigned to this NPI record is 23D2047786 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/14/2012 and was last updated on 5/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2103TB0200XPsychologistCognitive & BehavioralNo
3103TC0700XPsychologistClinicalNo
4103TP2701XPsychologistGroup PsychotherapyNo
5104100000XSocial WorkerNo
6122300000XDentistNo
7133V00000XDietitian, RegisteredNo
8152W00000XOptometristNo
9156FX1800XTechnician/TechnologistOpticianNo
10163W00000XRegistered NurseNo
11207Q00000XFamily MedicineNo
12207R00000XInternal MedicineNo
13208000000XPediatricsNo
14261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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