Green, Jacques Dewayne

Green, Jacques Dewayne is an sole proprietor health care provider with primary practice located at 359 Division Ave S , Grand Rapids MI 49503-4537. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Green, Jacques Dewayne can be contacted via phone (616) 685-3800.

Contact Information

Primary practice address
359 Division Ave S Grand Rapids MI 49503-4537
Phone: (616) 685-3800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6801089203 Michigan
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X C-03173 Michigan

Profile Details

NPI number 1841482791
LBN Legal business name Green, Jacques Dewayne
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2007
Last updated May 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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