CHERRY STREET SERVICES, INC. (NPI# 1891867495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891867495 |
| Entity Type | Organization |
| Organization Name | CHERRY STREET SERVICES, INC. |
| Other Organization Name | WESTSIDE HEALTH CENTER |
| Practice Address |
669 Stocking Ave Nw Grand Rapids MI 49504-5176 |
| Mailing Address |
100 Cherry St Se Grand Rapids MI 49503-4526 |
| Practice Telephone | 6162351480 |
| Practice Fax Number | 6164588102 |
| Mailing Telephone | 6169658200 |
| Mailing Fax Number | 6169405366 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | TASHA BLACKMON (CEO) |
| Authorized Official Telephone | 6169658200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | MI | Behavioral Health & Social Service Providers | |
| N | 122300000X | Dentist | Dental Providers | ||
| N | 133N00000X | Nutritionist | MI | Dietary & Nutritional Service Providers | |
| N | 163W00000X | Registered Nurse | MI | Nursing Service Providers | |
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Westside Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841449105 | Cherry Street Services, Inc. | Dentist | 101 Sheldon Blvd Se Ste 1, Grand Rapids, MI 49503-4950 | 2008-09-11 |
| 1710047303 | Cherry Street Services, Inc. | Social Worker | 1720 Plainfield Nw, Grand Rapids, MI 49505-4705 | 2006-12-12 |
| 1982764643 | Cherry Street Services, Inc. | Social Worker | 1800 Tremont Blvd Nw, Grand Rapids, MI 49504-4868 | 2006-12-11 |
| 1124187471 | Cherry Street Services, Inc. | Dentist | 2055 Rosewood Ave Se, Grand Rapids, MI 49506-5248 | 2006-12-06 |
| 1063586816 | Cherry Street Services, Inc. | Social Worker | 1215 Fulton St E, Grand Rapids, MI 49503-3849 | 2006-11-20 |
| 1770656605 | Cherry Street Services, Inc. | Pediatrics | 2125 Buchanan Sw, Grand Rapids, MI 49507 | 2006-11-16 |
| 1215414800 | Cherry Street Services, Inc. | Social Worker | 490 Century Ln, Holland, MI 49423 | 2018-07-26 |
| 1336399047 | Cherry Street Services, Inc. | Dentist | 101 Sheldon Blvd Se, Grand Rapids, MI 49503-4262 | 2008-09-30 |
| 1689731507 | Cherry Street Services, Inc. | Registered Nurse | 550 Cherry St Se, Grand Rapids, MI 49503-4748 | 2007-01-02 |
| 1669530986 | Cherry Street Services, Inc. | Counselor | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2006-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Cherry Street Services, Inc. | 1029 E 8th Ave, 1204, Denver, CO 80218 |
| Street Address |
669 STOCKING AVE NW |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49504-5176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225691496 | Steven Edelman | Counselor | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2019-04-15 |
| 1588175350 | Marie Elizabeth Selleck | Social Worker | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2017-10-19 |
| 1053838169 | Daniel Simon Stout | Physician Assistant | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2017-08-29 |
| 1942673595 | Ezequiel Rios | Dental Hygienist | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2015-11-04 |
| 1609207091 | Ashley Gary | Physician Assistant | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2013-12-10 |
| 1609110014 | Kaylin Joy Bolt | Social Worker | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2012-11-26 |
| 1538493184 | Joshlyn Litzenberger | Registered Nurse | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2009-09-30 |
| 1790915981 | Kayla Jean Morris-doyle | Social Worker | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2009-07-22 |
| 1851554299 | Zachary Pyles | Dentist | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2008-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477049518 | Mark Contreras | Nurse Practitioner | 72 Sheldon Blvd Se # 130, Grand Rapids, MI 49504 | 2018-07-02 |
| 1205338753 | Kelli Marie Selby | Physical Therapist | 235 Wealthy, Grand Rapids, MI 49504 | 2018-03-01 |
| 1871094474 | Kymiri Lyn Coles | Physical Therapist | 1000 Edison Ave Ne, Grand Rapids, MI 49504 | 2018-02-28 |
| 1881132744 | Courtney Glinka | Behavior Technician | 1149 Butterworth St Sw, Grand Rapids, MI 49504 | 2017-02-10 |
| 1649650300 | Alyson Renee Vela | Social Worker | 1256 Walker Ave Ne, Grand Rapids, MI 49504 | 2015-06-08 |
| 1508258500 | Grand Rapids Natural Health | Nutritionist | 638 Fulton Street W., Grand Rapids, MI 49504 | 2015-02-27 |
| 1144622598 | Robert Mclaren | Physical Therapist | 2807 Lake Michigan Dr Nw Ste 1, Grand Rapids, MI 49504 | 2014-09-17 |
| 1972854339 | Beth Ellen Gregory | Registered Nurse | 1956 Walker Avenue Northwest, Grand Rapids, MI 49504 | 2012-09-26 |
| 1588914147 | Unlimited Alternatives | Community/Behavioral Health | 282 Leonard, Grand Rapids, MI 49504 | 2012-09-11 |
| 1386912178 | Michael Allen Crawford | Pharmacist | 800 West Leonard Nw, Grand Rapids, MI 49504 | 2011-12-07 |
| Find all providers in zip 49504 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730471368 | Justin L Shields | Clinic/Center | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2011-05-16 |
| 1902002272 | Trinity Health - Michigan | Clinic/Center | 359 S Division Ave, Grand Rapids, MI 49503 | 2007-06-25 |
| 1811427826 | Catherine's Health Center | Clinic/Center | 1211 Lafayette Ave Ne, Grand Rapids, MI 49505-5092 | 2017-06-13 |
| 1962933416 | Trinity Health-michigan | Clinic/Center | 1246 Madison Ave Se, Grand Rapids, MI 49507-1761 | 2017-03-27 |
| 1023558533 | Cherry Health | Clinic/Center | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2017-03-02 |
| 1154584373 | Trinity Health - Michigan | Clinic/Center | 730 Grandville Ave Sw, Grand Rapids, MI 49503-4920 | 2008-07-08 |
| 1508063561 | Saint Mary's Health Services | Clinic/Center | 730 Grandville Ave Sw, Grand Rapids, MI 49503-4920 | 2007-07-02 |
| 1417154477 | St Mary's Hlth Svcs | Clinic/Center | 359 Division Ave S, Grand Rapids, MI 49503-4537 | 2007-07-02 |
| 1902002264 | St Marys Hlth Svcs | Clinic/Center | 245 Cherry St Se, Ste 306, Grand Rapids, MI 49503-4607 | 2007-06-25 |
| 1710182431 | Professional Financial Services | Clinic/Center | 1246 Madison Ave Se, Grand Rapids, MI 49507-1761 | 2007-06-21 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49504 |
Please comment or provide details below to improve the information on CHERRY STREET SERVICES, INC..
| 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.