Individual
BETHANY STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1939 DIVISION AVE S, GRAND RAPIDS, MI 49507-2480
(616) 247-3815
Mailing address
1939 DIVISION AVE S, GRAND RAPIDS, MI 49507-2480
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801121761
MI
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
02/23/2026
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