Stacey Michelle Vandenberge, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201012832 Issued in MI

Practice address

2922 Fuller Ave NE Ste 105
Grand Rapids, MI 49505-3459

Phone

(616) 327-6191

Fax

(616) 333-4928

NPI assigned

Feb 9, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacey Michelle Vandenberge Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Caya Therapies LLC

  • Occupational Therapist
  • Grand Rapids, MI
  • NPI 1962162040
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1265186233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 FULLER AVE NE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053459",
            "telephone_number": "616-327-6191",
            "fax_number": "616-333-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922 FULLER AVE NE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053459",
            "telephone_number": "616-327-6191",
            "fax_number": "616-333-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERGE",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201012832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "VANDENBERGE",
            "middle_name": "MICHELLE",
            "credential": "MSOT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ruth Jean Vandenberg, P.A.-C.
• Samantha Vandenberg, FNP
• Stacey Lynn Vandenberg, MA, LPC, NCC, CAADC
• William Christian Vandenberg, M.D.
• Kylie Jay Vandenberge
• Amy Vandenbos
• Erin Elizabeth Vandenbos, RDH
• Sarah Vandenbos, PA-C
• Karlina Vandenbosch
• Margaret Jane Vandenbosch

• Occupational Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.