Jerry B Vanleeuwen Phd Pc

LBN: Jerry B Vanleeuwen Phd Pc
Jerry B Vanleeuwen Phd Pc is an health care organization with primary practice located at 6255 28Th St Se Ste M , Grand Rapids MI 49546-6966. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as the primary health care specialty. Jerry B Vanleeuwen Phd Pc can be contacted via phone (616) 458-5294, or through Van Leeuwen, Jerry B. via phone (616) 458-5294.

Contact Information

Primary practice address
6255 28Th St Se Ste M Grand Rapids MI 49546-6966
Phone: (616) 458-5294
Fax: (616) 458-5295
Website:
Map and Directions
Authorized official contact:
Name: Van Leeuwen, Jerry B. PHD
Phone: (616) 458-5294

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X

Profile Details

NPI number 1497943146
LBN Legal business name Jerry B Vanleeuwen Phd Pc
DBA Doing business as
Authorized official Van Leeuwen, Jerry B. PHD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 9th, 2007
Last updated Dec 4th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497943146 NPPES
Michigan MEDICAID 1336340140

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