KIMBERLY NOVAK CTRS NPI 1609404805

NPI Information

  • NPI: 1609404805
  • Provider Name: KIMBERLY NOVAK, CTRS
  • Classification: Recreation Therapist - 225800000X
  • Entity Type: Individual
  • Address: 790 FULLER AVE NE
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 855-5226

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NPI Details

Kimberly Novak, CTRS is a recreation therapist in Grand Rapids, MI. The provider is a recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. Kimberly Novak, CTRS NPI is 1609404805. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

790 FULLER AVE NE
GRAND RAPIDS, MI
ZIP 49503-918
Phone: (616) 855-5226

The enumeration date for this NPI number is 4/1/2020 and was last updated on 3/3/2022.

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
1225800000XRecreation Therapist68065MICHIGANYes

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: 3/30/2025

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