Organization
MICHIGAN BEHAVIORAL CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC WILLMARTH PHD (PRESIDENT)
(616) 285-1377
Entity
Organization
Contact information
Practice address
2060 E PARIS AVE SE, SUITE 200, GRAND RAPIDS, MI 49546-6113
(616) 285-1377
(616) 285-1006
Mailing address
5555 GLENWOOD HILLS PKWY SE STE 2, GRAND RAPIDS, MI 49512-2091
(616) 940-2662
(616) 940-1965
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680D111357
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/28/2006
Last updated
03/30/2021
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