CHERRY STREET SERVICES INC NPI 1609555218

NPI Information

  • NPI: 1609555218
  • Provider Name: CHERRY STREET SERVICES, INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Address: 50 35TH ST SW
    GRAND RAPIDS, MI
    ZIP 49548
  • Phone: (616) 965-8200

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NPI Details

CHERRY STREET SERVICES, INC is a federally qualified health center (fqhc) clinic center in Grand Rapids, MI. CHERRY STREET SERVICES, INC NPI is 1609555218. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

50 35TH ST SW
GRAND RAPIDS, MI
ZIP 49548-100
Phone: (616) 965-8200

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 enumeration date for this NPI number is 7/12/2023 and was last updated on 7/12/2023.

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
1101Y00000XCounselorNo
2101YS0200XCounselorSchoolNo
3104100000XSocial WorkerNo
41041C0700XSocial WorkerClinicalNo
51041S0200XSocial WorkerSchoolNo
6122300000XDentistNo
7124Q00000XDental HygienistNo
8125J00000XDental TherapistNo
9126800000XDental AssistantNo
10133V00000XDietitian, RegisteredNo
11152W00000XOptometristNo
12163WS0200XRegistered NurseSchoolNo
13207Q00000XFamily MedicineNo
14208000000XPediatricsNo
15261QF0400XClinic/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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