Provider Demographics
NPI:1427522853
Name:KATIE HENSLEY-MINKS LMSW
Entity type:Organization
Organization Name:KATIE HENSLEY-MINKS LMSW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LLC
Authorized Official - Phone:616-914-7310
Mailing Address - Street 1:4676 THORNBERRY HILL CT NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9489
Mailing Address - Country:US
Mailing Address - Phone:616-914-7310
Mailing Address - Fax:
Practice Address - Street 1:5060 CASCADE RD SE STE G
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3808
Practice Address - Country:US
Practice Address - Phone:616-914-7310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty