Provider Type Icon

PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1245372150


NPI Information

NPI: 1245372150
Provider Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Classification: Psychologist - 103T00000X
Entity Type: Organization
Address:
300 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548
Phone: (616) 455-5000
Get Directions

PINE REST CHRISTIAN MENTAL HEALTH SERVICES is a psychologist in Grand Rapids, MI. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI is 1245372150. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548-927
Phone: (616) 455-5000

The provider's authorized official is Diane Fennema .
The authorized official title is Managed Care Administrator and has the following contact phone number (616) 281-6372.

The enumeration date for this NPI number is 2/14/2007 and was last updated on 11/4/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2103G00000XClinical NeuropsychologistNo
3103T00000XPsychologistYes
4104100000XSocial WorkerNo
5207R00000XInternal MedicineNo
6208000000XPediatricsNo
72084P0800XPsychiatry & NeurologyPsychiatryNo
8363A00000XPhysician AssistantNo
9363L00000XNurse PractitionerNo

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.