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PINE REST CHRISTIAN MENTAL HEATTH SERVICES NPI 1508875667


NPI Information

NPI: 1508875667
Provider Name: PINE REST CHRISTIAN MENTAL HEATTH SERVICES
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
310 LAFAYETTE AVE SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 913-1400
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PINE REST CHRISTIAN MENTAL HEATTH SERVICES is a psychiatry psychiatry neurology in Grand Rapids, MI. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. PINE REST CHRISTIAN MENTAL HEATTH SERVICES NPI is 1508875667. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

310 LAFAYETTE AVE SE
GRAND RAPIDS, MI
ZIP 49503-693
Phone: (616) 913-1400

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 8/7/2006 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
1103T00000XPsychologistNo
2104100000XSocial WorkerNo
32084P0800XPsychiatry & NeurologyPsychiatryYes
4363A00000XPhysician AssistantNo
5363L00000XNurse PractitionerNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1800D16222OTHERMICHIGANSOCIAL WORKERS
2260D17625OTHERMICHIGANPSYCHIATRISTS
3500D11133OTHERMICHIGANNURSE PRACT.
4680D16189OTHERMICHIGANPSYCHOLOGISTS
5P10D11275OTHERMICHIGANPSYCHOLGOGISTS-MA, DOCTOR

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

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