DR. ALISHA RENEE THIBAULT (NPI# 1295264034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295264034 |
| Entity Type | Individual |
| Full Name | DR. ALISHA RENEE THIBAULT |
| Credential | MD |
| Practice Address |
300 68th Street Se Pine Rest Christian Mental Health Services Grand Rapids MI 49548 |
| Practice Telephone | (616) 456-0842 |
| Practice Fax Number | 6165595864 |
| Mailing Telephone | 6164560842 |
| Mailing Fax Number | 6165595864 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2019-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4351032045 | MI | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4301111913 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
300 68TH STREET SE PINE REST CHRISTIAN MENTAL HEALTH SERVICES |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386738953 | Sharita Montiez Hall | Social Worker | 300 68th Street Se, Grand Rapids, MI 49548 | 2006-10-03 |
| 1841791357 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 300 68th Street Se, Grand Rapids, MI 49548 | 2018-02-21 |
| 1902336100 | Danielle Pariesee Zazaian | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-20 |
| 1912437245 | Zachary David Loy | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-19 |
| 1770013203 | Alexandra Lynn Tepkasetkul | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-18 |
| 1982134623 | Weston Mark Anderson | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-15 |
| 1770013559 | Russell Brian Fridson | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-14 |
| 1861921041 | Heidi Juel Vrolijk | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-09 |
| 1477082931 | Ryan Joseph Yoon | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-08 |
| 1679002497 | Todd Matthew Simmons | Psychiatry & Neurology | 300 68th Street Se, Pine Rest Christian Mental Health Services, Grand Rapids, MI 49548 | 2017-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319811 | Pooja Patel | Social Worker | Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2018-09-10 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1871099481 | Baymark of Michigan, Inc. | Clinic/Center | 5500 Division Avenue Se, Kentwood, MI 49548 | 2018-04-03 |
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1821548504 | Alison Anderson | Technician, Other | 103 Roth St Se, Grand Rapids, MI 49548 | 2016-10-06 |
| 1831540152 | Jesse Aubil | Counselor | 264 Montebello St. Se 49548, Grand Rapids, MI 49548 | 2016-06-28 |
| 1306237920 | Sarah Benton | Social Worker | 225 Colrain St Sw, 2, Grand Rapids, MI 49548 | 2015-02-18 |
| 1578996856 | Karen Marie Irving | Social Worker | 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2013-08-09 |
| 1740348044 | Robert Kenneth Richmond | Preventive Medicine | 551 36th Street. Se, Wyoming, MI 49548 | 2006-12-05 |
| 1255432977 | Rodney Ray Senneker | Podiatrist | 6703 S Division Ave, Grand Rapids, MI 49548 | 2006-09-26 |
| Find all providers in zip 49548 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1124462437 | Veritas Integrated Psychiatric Care, Pllc | Psychiatry & Neurology | 3265 Walker Ave Nw, Suite D, Grand Rapids, MI 49544-9708 | 2013-04-18 |
| 1982835526 | Mon C Poulose | Psychiatry & Neurology | 3225 N Evergreen Drive Ne, Suite 301, Grand Rapids, MI 49525 | 2009-07-30 |
| 1972652972 | Radosveta Stoyanov | Psychiatry & Neurology | 3225 N Evergreen Dr Ne, Grand Rapids, MI 49525-9334 | 2007-01-09 |
| 1679633994 | Philip C. Haines | Psychiatry & Neurology | 1011 Parchment Dr Se, Grand Rapids, MI 49546-3664 | 2006-12-08 |
| 1669546537 | Holly Ann Perkins | Psychiatry & Neurology | 2894 Thornapple River Dr Se, Grand Rapids, MI 49546-6857 | 2006-11-20 |
| 1801966122 | Theodore Fitch Mauger | Psychiatry & Neurology | 1325 Thornapple River Dr Se, Grand Rapids, MI 49546-9736 | 2006-11-08 |
| 1154407807 | Josharon Mutchler | Psychiatry & Neurology | 2035 28th St Se, Suite P, Grand Rapids, MI 49508 | 2006-10-27 |
| 1760581524 | Elmer William Fowler Jr. | Psychiatry & Neurology | 3351 Claystone St Se, Suite 212, Grand Rapids, MI 49546-5781 | 2006-09-21 |
| 1578676797 | Haith Place Inc | Psychiatry & Neurology | 2460 Burton St Se Ste 101, Grand Rapids, MI 49546-4806 | 2006-08-15 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49548 |
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| 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.