Provider Demographics
NPI:1699898478
Name:VIRGINIA SCHOLTEN MSW LMSW LLC
Entity type:Organization
Organization Name:VIRGINIA SCHOLTEN MSW LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:SCHOLTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-745-4426
Mailing Address - Street 1:4467 CASCADE AVE SE
Mailing Address - Street 2:STE #4481
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:616-745-4426
Mailing Address - Fax:616-361-2819
Practice Address - Street 1:4467 CASCADE AVE SE
Practice Address - Street 2:STE #4481
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-745-4426
Practice Address - Fax:616-361-2819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010698811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOPO8770Medicare ID - Type Unspecified