MR. MARK S WALSTROM (NPI# 1780750844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780750844 |
| Entity Type | Individual |
| Full Name | MR. MARK S WALSTROM |
| Credential | L.P.C. |
| Practice Address |
967 Spaulding Ave Se Suite E Ada MI 49301-3700 |
| Practice Telephone | 6166332170 |
| Mailing Telephone | 6166332170 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2009-01-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401003116 | MI | Behavioral Health & Social Service Providers |
| Street Address |
967 SPAULDING AVE SE SUITE E |
| City | ADA |
| State | MI |
| Zip Code | 49301-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568714863 | Robert Labadie Funaro | Psychologist | 967 Spaulding Ave Se, Suite E, Ada, MI 49301-3700 | 2012-10-10 |
| 1194088377 | Kjc323pllc | Psychologist | 967 Spaulding Ave Se, Suite E, Ada, MI 49301-3700 | 2012-06-21 |
| 1699904193 | Frank Stanley Renberg | Psychologist | 967 Spaulding Ave Se, Suite D, Ada, MI 49301-3700 | 2009-07-07 |
| 1568608230 | Richard Raleigh Raubolt | Psychologist | 967 Spaulding Ave Se, Suite D, Ada, MI 49301-3700 | 2008-12-30 |
| 1992991020 | Kathleen Delp Acsw Pllc | Social Worker | 967 Spaulding Ave Se, Ada, MI 49301-3700 | 2007-09-21 |
| 1508999277 | Dr. Julia A. Mohr, Plc | Psychologist | 967 Spaulding Ave Se, Suite E, Ada, MI 49301-3700 | 2007-03-13 |
| 1548393283 | Julia A Mohr | Psychologist | 967 Spaulding Ave Se, Suite E, Ada, MI 49301-3700 | 2007-03-13 |
| 1982730040 | Denise Marie Hames | Social Worker | 967 Spaulding Ave Se, Suite E, Ada, MI 49301-3700 | 2007-02-25 |
| 1083765812 | Kathleen Jandernoa Cramer | Psychologist | 967 Spaulding Ave Se, Ada, MI 49301-3700 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326608720 | Mary Zuidema Lmsw LLC | Social Worker | 938 Spaulding Ave Se, Ada, MI 49301 | 2019-06-18 |
| 1689115040 | Bright Life Therapies LLC | Physical Therapist | 7690 Candlewood Dr, Ada, MI 49301 | 2017-03-17 |
| 1639425747 | Gary W Watson | Social Worker | 975 Spaulding Ave Ste D., Ada, MI 49301 | 2012-07-25 |
| 1821361353 | Paul George Theodore | Obstetrics & Gynecology | 660 South Whitman Ct. Se (retired), Ada, MI 49301 | 2012-02-14 |
| 1265768097 | Mary Kathryn Bennett | Social Worker | 983 Spaulding Ave. S.e., Ada, MI 49301 | 2009-10-29 |
| 1770739997 | Sheila R. Mccormack | Psychologist | 983 Spaulding St., Se, Ada, MI 49301 | 2008-08-08 |
| 1932321593 | Allison Leigh Stevens | Psychologist | 4670 E Fulton Ave Se, Suite 101, Ada, MI 49301 | 2007-05-03 |
| 1750434239 | Sarah J Ash | Registered Nurse | 983 Spaulding Office Annex, Ada, MI 49301 | 2007-01-19 |
| 1396756326 | Christine Marie Olree | Clinical Nurse Specialist | 200 Jefferson, Saint Marys Healthcare, Grand Rapids, MI 49301 | 2006-08-11 |
| 1174548606 | Kurt E Schabes | Dentist | 7210 Headley Se, Ada, MI 49301 | 2006-07-13 |
| Find all providers in zip 49301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801321 | Yolanda Cummings Counseling, Inc. | Counselor | 24900 County Road 1512, Ada, OK 74820-0994 | 2020-08-10 |
| 1033574488 | Wendy Sue Biddle | Counselor | 2021 Te Ata Dr., Ada, OK 74820 | 2015-12-29 |
| 1831563378 | Jahna Buckaloo | Counselor | 1300 Hoppe Blvd Ste 4, Ada, OK 74820-2319 | 2015-11-20 |
| 1922485739 | Clare Marie Mccullough | Counselor | 477 Edgeworthe Dr Se, Ada, MI 49301-7809 | 2015-04-30 |
| 1083091037 | Karen Feaster | Counselor | 455 Greentree Ln Ne, Ada, MI 49301-9706 | 2015-04-29 |
| 1407279250 | Kathryn Zuverink | Counselor | 7195 Thornapple River Dr Se Ste C, Ada, MI 49301-8411 | 2014-01-30 |
| 1568891885 | Elizabeth Jane Helmstead | Counselor | 6343 Redington Dr Se, Ada, MI 49301-9021 | 2013-11-07 |
| 1356782965 | Barbara Jean Fulton | Counselor | 1500 Hoppe Blvd, Suite 4, Ada, OK 74820-2311 | 2013-07-11 |
| 1588968275 | Chickasaw Nation - Family Services | Counselor | 1300 Hoppe Blvd Ste 1, Ada, OK 74820-2319 | 2011-01-10 |
| 1689985939 | Paige Noelle Williams | Counselor | 1331 Mockingbird Ln, Ada, OK 74820-8567 | 2010-07-01 |
| Find all providers in ADA | ||||
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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.