Provider Demographics
NPI:1932754694
Name:WELNIAK, AUBREY ANN (LMSW)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:ANN
Last Name:WELNIAK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:ANN
Other - Last Name:KIRBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1466 GRIDLEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-2410
Mailing Address - Country:US
Mailing Address - Phone:616-914-3527
Mailing Address - Fax:
Practice Address - Street 1:3800 LAKE MICHIGAN DR NW STE 103
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534-4583
Practice Address - Country:US
Practice Address - Phone:616-805-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011135341041C0700X
MI6801105198104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker