Vandergoot, Mary Elizabeth

Vandergoot, Mary Elizabeth is an sole proprietor health care provider with primary practice located at 60 Monroe Ctr Nw Suite 8-D, Grand Rapids MI 49503-2916. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Vandergoot, Mary Elizabeth can be contacted via phone (616) 957-3477.

Contact Information

Primary practice address
60 Monroe Ctr Nw Suite 8-D Grand Rapids MI 49503-2916
Phone: (616) 957-3477
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6201002122 Michigan
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101005656 Michigan

Profile Details

NPI number 1447220819
LBN Legal business name Vandergoot, Mary Elizabeth
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2006
Last updated Sep 14th, 2011 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1447220819 NPPES
Michigan Other 680D14542 BLUE CROSS BLUE SHIELD

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