NPIMap

Organization Active NPI

Life Guidance Services

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1336185032
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
LIFE GUIDANCE SERVICES
Practice address
1400 Leonard St NE
Grand Rapids, MI 49505-5515
Phone
(616) 954-1992
Fax
(616) 954-1998
NPI assigned
Jun 21, 2006
Last updated
Jun 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Authorized official

Name
Mr. Dan L Fogel, MA,LLP
Title
Executive Director
Phone
(616) 954-1992

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Social Worker 104100000X NU Primary

Addresses

Primary practice location

1400 Leonard St NE
Grand Rapids, MI 49505-5515

Mailing address

330 Eastern NE
Grand Rapids, MI 49503
Phone (616) 776-0891

National Provider Directory

National Provider Directory

Locations

1400 Leonard St NE
Grand Rapids, MI 49505
Phone (616) 774-0633

330 Eastern Ave SE
Grand Rapids, MI 49503
Phone (616) 776-0891

3351 Claystone St SE
Grand Rapids, MI 49546
Phone (616) 954-1991

3351 Claystone St SE
Ste 112
Grand Rapids, MI 49546
Phone (616) 954-1991

3351 Claystone St SE
Ste 212
Grand Rapids, MI 49546
Phone (616) 954-1991

348 S Waverly Rd
Ste 3
Holland, MI 49423
Phone (888) 877-7720

301 W Main St
Ionia, MI 48846
Phone (888) 877-7720

Practitioners & affiliated clinicians

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1336185032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 EASTERN NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-776-0891",
            "fax_number": "616-233-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055515",
            "telephone_number": "616-954-1992",
            "fax_number": "616-954-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE GUIDANCE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "FOGEL",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "616-954-1992",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA,LLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.