MARY BETH CHILD


Address: 4701 Plainfield Ave Ne, Suite C, Grand Rapids, MI 49525-1644
Phone: 6163613398

MARY BETH CHILD (NPI# 1073722542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073722542
Entity Type Individual
Full Name MARY BETH CHILD
Credential LLP
Practice Address 4701 Plainfield Ave Ne
Suite C
Grand Rapids
MI 49525-1644
Practice Telephone 6163613398
Practice Fax Number 6163613395
Mailing Telephone 6163613398
Mailing Fax Number 6163613395
Enumeration Date 2007-05-22
Last Update Date 2011-03-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TB0200X Psychologist
Specialization: Cognitive & Behavioral
6301010573 MI Behavioral Health & Social Service Providers

Office Location

Street Address 4701 PLAINFIELD AVE NE
SUITE C
City GRAND RAPIDS
State MI
Zip Code 49525-1644

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1154645349 Shannon Leigh Miller Social Worker 4701 Plainfield Ave Ne, Suite C, Grand Rapids, MI 49525-1644 2010-03-17
1043454325 Monica Maria Michael Counselor 4701 Plainfield Ave Ne, Suite C, Grand Rapids, MI 49525-1644 2009-04-30
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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

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1164694006 Andrea Lee Rotzien Psychologist 4701 Plainfield Ave. Ne, Suite C, Grand Rapids, MI 49525 2008-04-01
1427288000 Carrie Louise Labarge Psychologist 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 2009-07-17
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1033398581 Sandra Jean Wynn-stelt Psychologist 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 2007-11-01
1508057548 Laura Lee Bennett Psychologist 1007 Parchment Dr Se, Grand Rapids, MI 49546-3664 2007-08-06
1689740078 Gregory Scot Deacon Psychologist 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 2006-11-28
1649208018 Victoria L Wilson Psychologist 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 2006-06-28

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Competitor

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City GRAND RAPIDS
Zip Code 49525

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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