Child & Family Therapy Consultants

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6801090517 Issued in MI

Legal business name

CHILD & FAMILY THERAPY CONSULTANTS

Practice address

114 Vine St
Gobles, MI 49055-9693

Phone

(269) 352-3558

NPI assigned

Mar 20, 2012

Last updated

Mar 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grachelle Alyce Sherburne, LMSW

Title

Clinical Therapist

Phone

(269) 352-3558

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1396010617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 VINE ST",
            "address_2": "P.O. BOX 373",
            "city": "GOBLES",
            "state": "MI",
            "postal_code": "490559693",
            "telephone_number": "269-352-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 VINE ST",
            "city": "GOBLES",
            "state": "MI",
            "postal_code": "490559693",
            "telephone_number": "269-352-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & FAMILY THERAPY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "SHERBURNE",
        "authorized_official_first_name": "GRACHELLE",
        "authorized_official_middle_name": "ALYCE",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "269-352-3558",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801090517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Gobles, MI
• Providers in Gobles, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.