Provider Demographics
NPI:1528667839
Name:MICHELLE VANNOORD LLC
Entity type:Organization
Organization Name:MICHELLE VANNOORD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANNOORD
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:616-227-4688
Mailing Address - Street 1:393 GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-9602
Mailing Address - Country:US
Mailing Address - Phone:616-227-4688
Mailing Address - Fax:
Practice Address - Street 1:393 GARDEN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-9602
Practice Address - Country:US
Practice Address - Phone:616-227-4688
Practice Address - Fax:616-294-4960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty