ARDEAN BETH BROCK-VANDERWALL (NPI# 1013147495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013147495 |
| Entity Type | Individual |
| Full Name | ARDEAN BETH BROCK-VANDERWALL |
| Other Name | ARDEAN BETH BROCK-VANDERWALL |
| Credential | M.DIV., M.A. |
| Practice Address |
2828 Kraft Ave. Grand Rapids MI 49512 |
| Mailing Address |
3208 Woodberry Drive Grand Rapids MI 49512 |
| Practice Telephone | 6169499550 |
| Practice Fax Number | 6169499551 |
| Mailing Telephone | 6168936420 |
| Mailing Fax Number | 6168919676 |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2015-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401011131 | MI | Behavioral Health & Social Service Providers |
| Street Address |
2828 KRAFT AVE. |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1013493733 | Pharmascript of Michigan Gr LLC | Pharmacy | 2661 29th St. Se Suite A, Grand Rapids, MI 49512 | 2018-07-16 |
| 1245736040 | Cassandra Slater | Technician, Other | 2925 Breton Rd Se, Grand Rapids, MI 49512 | 2018-04-02 |
| 1235632704 | John Mitchell Tanja | Occupational Therapist | 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 | 2018-03-12 |
| 1952829855 | Sarah Harlow | Physical Therapist | 2951 44th St Se, Kentwood, MI 49512 | 2017-08-31 |
| 1194248815 | Melinda Huizenga | Registered Nurse | 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 | 2017-07-25 |
| 1659812931 | Frantzie Pierre | Counselor | 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 | 2017-03-20 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1518282631 | Melanie Anne Hogeterp | Social Worker | 3180 East Paris Se, Kentwood, MI 49512 | 2010-03-31 |
| 1427294909 | Marcia Rappleye | Counselor | 3250 36th St Se, Grand Rapids, MI 49512 | 2009-01-05 |
| Find all providers in zip 49512 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020558 | Danita Mcalister | Counselor | 2504 Normandy Dr Se Apt 213b, Grand Rapids, MI 49506-7901 | 2020-10-16 |
| 1013521574 | Megan Flier | Counselor | 3744 Bradford St Ne, Grand Rapids, MI 49525-3325 | 2020-09-02 |
| 1457962078 | Cappon Consulting LLC | Counselor | 1344 Mayfield Ave Ne, Grand Rapids, MI 49505-5525 | 2020-08-17 |
| 1124644596 | Travis James Atkinson | Counselor | 3000 Wausaukee Dr Ne, Grand Rapids, MI 49525-1916 | 2020-06-22 |
| 1639790207 | Tracey Wicks | Counselor | 78 Centerbrook St Se, Grand Rapids, MI 49548-6902 | 2020-05-05 |
| 1174160592 | Lindsey Elizabeth Rosa | Counselor | 845 5th St Nw Apt 2, Grand Rapids, MI 49504-5163 | 2019-12-04 |
| 1710530597 | New Way Counseling LLC | Counselor | 1971 E Beltline Ave Ne Ste C, Grand Rapids, MI 49525-7045 | 2019-07-19 |
| 1588216048 | Kate Jack | Counselor | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2019-07-15 |
| 1104488105 | Travis Gordon | Counselor | 800 Monroe Ave Nw Ste 319, Grand Rapids, MI 49503-1451 | 2019-07-01 |
| 1255996575 | The Family Therapy Place Pllc | Counselor | 731 Front Ave Nw, Grand Rapids, MI 49504-5366 | 2019-05-02 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49512 |
Please comment or provide details below to improve the information on ARDEAN BETH BROCK-VANDERWALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.