Provider Demographics
NPI:1285961136
Name:KAREN WASSINK, LCSW, PLLC
Entity type:Organization
Organization Name:KAREN WASSINK, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYLSMA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:616-786-3304
Mailing Address - Street 1:3124 N WELLNESS DR
Mailing Address - Street 2:SUITE 30
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8121
Mailing Address - Country:US
Mailing Address - Phone:616-786-3304
Mailing Address - Fax:616-786-3375
Practice Address - Street 1:3124 N WELLNESS DR
Practice Address - Street 2:SUITE 30
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8121
Practice Address - Country:US
Practice Address - Phone:616-786-3304
Practice Address - Fax:616-786-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health