Organization
CHERRY STREET SERVICES INC
Active
Parent organization
CHERRY STREET SERVICES INC
Other names
Leonard Street Counseling Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHERRY STREET SERVICES INC
Authorized official
MR. TASHA BLACKMON (EXECUTIVE DIRECTOR)
(616) 776-2121
Entity
Organization
Contact information
Practice address
1400 LEONARD STREET NE, GRAND RAPIDS, MI 49505-5515
(616) 954-1991
(616) 954-1998
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 965-8200
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
Other
Enumeration date
09/09/2011
Last updated
10/01/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us