| NPI | 1043592629 |
|---|---|
| Doing Business As | LEONARD STREET COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | TASHA BLACKMON Executive Director 616-776-2121 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2021-10-01 |