MR. JEFFREY ALAN BOOTZIN (NPI# 1295986933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295986933 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY ALAN BOOTZIN |
| Credential | EDS, LLP |
| Practice Address |
330 Eastern Ave Se Grand Rapids MI 49503-4737 |
| Mailing Address |
330 Eastern Ave Se Grand Rapids MI 49503 |
| Practice Telephone | 6167760891 |
| Practice Fax Number | 6162330672 |
| Mailing Telephone | 6167760891 |
| Mailing Fax Number | 6162330672 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
6301002673 | MI | Behavioral Health & Social Service Providers |
| Street Address |
330 EASTERN AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-4737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609416197 | Alexander Sydney Houseknecht | Psychologist | 337 Visser Pl Se, Grand Rapids, MI 49506-1541 | 2020-01-13 |
| 1730745852 | Kls Counseling LLC | Psychologist | 688 Cascade West Pkwy Se, Grand Rapids, MI 49546-2171 | 2019-05-14 |
| 1609347285 | Luwillis Gibson | Psychologist | 1014 Dunham St Se, Grand Rapids, MI 49506-2659 | 2018-12-07 |
| 1598257966 | Austin Knight | Psychologist | 1010 Watson St Sw, Grand Rapids, MI 49504-6148 | 2018-06-01 |
| 1609203694 | Lynn Jackson | Psychologist | 456 Plymouth Ave Ne Ste B, Grand Rapids, MI 49505 | 2013-10-04 |
| 1184996969 | Joseph Edward Budnick | Psychologist | 1150 Brownwood Ave Nw, Grand Rapids, MI 49504-3653 | 2012-02-08 |
| 1265660963 | Gary Michael Cole | Psychologist | 1115 Ball Ave Ne Bldg C, Grand Rapids, MI 49505-5904 | 2009-07-01 |
| 1073763710 | Kylene Lynn Schipper | Psychologist | 3300 36th St, Grand Rapids, MI 49518-0007 | 2008-09-30 |
| 1770730434 | Kurt Thomas Ellis | Psychologist | 4920 Plainfield Ave Ne, Suite C, Grand Rapids, MI 49525-1010 | 2008-08-25 |
| 1437332871 | Jeanette Mcdowell Forrest | Psychologist | 233 Fulton St E Ste 104, Grand Rapids, MI 49503-3261 | 2007-12-07 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on MR. JEFFREY ALAN BOOTZIN.
| 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.