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PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1598138810


NPI Information

NPI: 1598138810
Provider Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Classification: Physician Assistant - 363A00000X
Entity Type: Organization
Address:
1870 LEONARD ST NE
GRAND RAPIDS, MI
ZIP 49505
Phone: (616) 956-9619
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PINE REST CHRISTIAN MENTAL HEALTH SERVICES is a physician assistant in Grand Rapids, MI. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI is 1598138810. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1870 LEONARD ST NE
GRAND RAPIDS, MI
ZIP 49505-650
Phone: (616) 956-9619

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

The enumeration date for this NPI number is 11/9/2015 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
1101YP2500XCounselorProfessionalMICHIGANNo
2103T00000XPsychologistMICHIGANNo
3104100000XSocial WorkerMICHIGANNo
42084P0800XPsychiatry & NeurologyPsychiatryMICHIGANNo
5363A00000XPhysician AssistantMICHIGANYes
6363L00000XNurse PractitionerMICHIGANNo

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: 11/14/2023

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.