CHERRY STREET SERVICES INC (NPI# 1386926004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386926004 |
| Entity Type | Organization |
| Organization Name | CHERRY STREET SERVICES INC |
| Other Organization Name | SOUTHSIDE HEALTH CENTER |
| Practice Address |
2303 Kalamazoo Ave Se Grand Rapids MI 49507-3780 |
| Mailing Address |
100 Cherry St Se Grand Rapids MI 49503-4526 |
| Practice Telephone | 6169658390 |
| Practice Fax Number | 6162548192 |
| Mailing Telephone | 6169658200 |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2015-09-11 |
| Authorized Official Name | CHRIS SHEA (CEO) |
| Authorized Official Telephone | 6167762129 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHERRY STREET SERVICES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Southside Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104423508 | Cherry Street Services Inc | Community/Behavioral Health | 100 Wexford St Se Rm 214, Wyoming, MI 49548-2212 | 2020-10-08 |
| 1265081418 | Cherry Street Services Inc | Clinic/Center | 2125 Wrenwood St Sw Ofc Therapist, Wyoming, MI 49519-2362 | 2019-09-10 |
| 1184974263 | Cherry Street Services Inc | Counselor | 2929 Burlingame Ave Sw, Wyoming, MI 49509-2609 | 2012-09-14 |
| 1346600905 | Cherry Street Services Inc | Clinic/Center | 1611 Oak Ave, Muskegon, MI 49442-2468 | 2016-02-25 |
| 1427438944 | Cherry Street Services Inc | Clinic/Center | 1033 Healthcare Dr, Charlotte, MI 48813-1058 | 2015-06-01 |
| 1184015539 | Cherry Street Services Inc | Clinic/Center | 204 E Muskegon St, Cedar Springs, MI 49319-9326 | 2015-02-06 |
| 1962800680 | Cherry Street Services Inc | Dentist | 1230 W State St, Hastings, MI 49058-9712 | 2014-12-11 |
| 1316340094 | Cherry Street Services Inc | Social Worker | 421 Fountain St Ne, Grand Rapids, MI 49503-3334 | 2014-10-08 |
| 1801298716 | Cherry Street Services Inc | Counselor | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2014-09-23 |
| 1396165601 | Cherry Street Services Inc | Dentist | 100 Cherry Street, Grand Rapids, MI 49503 | 2014-04-25 |
| Street Address |
2303 KALAMAZOO AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49507-3780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972530772 | Ravonne Jennell Foster | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2006-06-27 |
| 1386242345 | Lisa Elaine Pline | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2020-10-13 |
| 1336600741 | Daniel Leroy Francis | Psychologist | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2019-03-28 |
| 1114402963 | Elizabeth Gwinnett Josey | Counselor | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2018-09-27 |
| 1528573730 | Ezequiel G Garcia | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507 | 2017-12-11 |
| 1598274573 | Rachael Marie Kohler | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2017-09-22 |
| 1407399488 | Christopher Johnson | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2016-11-23 |
| 1669915625 | Leah Lappan | Counselor | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507 | 2016-11-23 |
| 1275901670 | Rachel Schaedel-patchava | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2015-09-02 |
| 1376928515 | Crystal Meeusen | Social Worker | 2303 Kalamazoo Ave Se, Grand Rapids, MI 49507-3780 | 2015-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487156956 | Kristen Zvirbulis Keeter | Physical Therapist | 625 Kenmoor Ave. Se Ste 306, Grand Rapids, MI 49507 | 2018-03-01 |
| 1508371758 | Vanessa Woodard | Case Manager/Care Coordinator | 1939 S. Division Ave., Grand Rapids, MI 49507 | 2017-12-11 |
| 1306350624 | Courtney Nicole Porter | Social Worker | 1979 S Division Ave., Grand Rapids, MI 49507 | 2017-11-22 |
| 1518496900 | 733 Prince LLC | Custodial Care Facility | 733 Prince St Se, Grand Rapids, MI 49507 | 2017-06-08 |
| 1720515406 | Tiffanie Ryder | Massage Therapist | 1110 Merrified St, Grand Rapids, MI 49507 | 2017-05-12 |
| 1619404308 | Shedrice's Afc | Respite Care | 246 Powell Se Ave, Grand Rapids, MI 49507 | 2017-05-12 |
| 1992171748 | Richard Lavell Flowers | Non-emergency Medical Transport (VAN) | 1447 Elliott, Grand Rapids, MI 49507 | 2015-08-17 |
| 1982096087 | Jordana Seebeck | Social Worker | 1939 S. Division Se, Grand Rapids, MI 49507 | 2015-02-26 |
| 1083973135 | Carla May Waite | Social Worker | 1939 South Division, Grand Rapids, MI 49507 | 2012-05-10 |
| 1740550037 | Jamie Lee Dalton | Social Worker | 2017 College Ave Se, Grand Rapids, MI 49507 | 2012-01-04 |
| Find all providers in zip 49507 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945564 | Amanda Kubiak | Psychologist | 1115 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2019-01-03 |
| 1760975460 | Kayleigh Lambert | Psychologist | 324 Lyon St Ne, Grand Rapids, MI 49503-5607 | 2018-06-07 |
| 1174051692 | Rodney Pallett | Psychologist | 1115 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2017-05-29 |
| 1720375157 | Heart of The City | Psychologist | 100 Cherry St Se, Grand Rapids, MI 49503 | 2011-07-06 |
| 1568667400 | Patrick John Witri | Psychologist | 455 Cherry St Se, Suite O, Grand Rapids, MI 49503-4658 | 2007-06-20 |
| 1316073562 | Marsha Jacqueline Cable | Psychologist | 3949 Sparks Dr Se, Suite 103, Grand Rapids, MI 49546-6110 | 2007-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972137883 | Lazarusman Consulting, Pllc | Psychologist | 2416 Peck St, Muskegon Hts, MI 49444-1431 | 2020-02-29 |
| 1861031189 | Christina M Kaplan, Pllc | Psychologist | 39520 Woodward Ave Ste 201, Bloomfield Hills, MI 48304-5057 | 2020-01-03 |
| 1184273716 | Drbrandi | Psychologist | 16250 Northland Dr Ste 240, Southfield, MI 48075-5227 | 2019-09-06 |
| 1790145548 | Cecil Cosey IIi | Psychologist | 11000 W Micnichols, Detroit, MI 48238 | 2016-03-07 |
| 1508202920 | Abaris Health | Psychologist | 2501 Rochester Ct, Troy, MI 48083-1875 | 2013-05-13 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| 1003161282 | Michael George Brock | Psychologist | 2514 Biddle Avenue, Wyandotte, MI 48192 | 2012-07-13 |
| 1972860005 | Samaritas | Psychologist | 128 S Cochran Ave, Charlotte, MI 48813-1510 | 2012-04-13 |
| 1619254042 | Kathryn Bartz | Psychologist | 500 Barfield Dr., Hastings, MI 49058-9018 | 2011-11-14 |
| 1609100627 | Laytoya Chevette Lambeth | Psychologist | 51255 Luke Ln, Novi, MI 48374-1004 | 2009-09-23 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49507 |
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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.