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PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1609884642


NPI Information

NPI: 1609884642
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
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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 1609884642. 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 8/4/2006 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
1103T00000XPsychologistYes

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
1700D16083OTHERMICHIGANBC/BS MA, LLP/DOCTORAL

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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