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CATHERINE A VANDEWEGE LLC NPI 1912471863


NPI Information

NPI: 1912471863
Provider Name: CATHERINE A VANDEWEGE LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
800 MONROE AVE NW STE 201
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 574-4098
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CATHERINE A VANDEWEGE LLC is a mental health (including community mental health center) clinic center in Grand Rapids, MI. CATHERINE A VANDEWEGE LLC NPI is 1912471863. The provider is registered as an organization entity type.

The provider's business location address is:

800 MONROE AVE NW STE 201
GRAND RAPIDS, MI
ZIP 49503-448
Phone: (616) 574-4098
Fax: (313) 202-8257

The provider's authorized official is Catherine Anne Hinton Vandewege .
The authorized official title is Clinical Social Worker and has the following contact phone number (616) 574-4098.

The enumeration date for this NPI number is 1/14/2019 and was last updated on 1/14/2019.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

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
11225245517MEDICAIDMICHIGAN

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

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