# CHERRY STREET SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801298716
- **Authorized official:** MR. CHRIS SHEA (CEO)
- **Authorized official phone:** (616) 776-2129

## Contact information

- **Practice address:** 100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
- **Practice address phone:** (616) 965-8200
- **Practice address fax:** (616) 940-5366
- **Mailing address:** 100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
- **Mailing address phone:** (616) 965-8200
- **Mailing address fax:** (616) 940-5366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/23/2014
- **Last updated:** 09/23/2014