Organization
CHERRY STREET SERVICES, INC.
Active
Other names
Cherry Street Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA BLACKMON (CEO)
(616) 965-8215
Entity
Organization
Contact information
Practice address
550 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 235-7289
(616) 235-0739
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 235-7272
(616) 235-7506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
MI
122300000X
Dentist
—
—
133V00000X
Registered Dietitian
—
—
163W00000X
Registered Nurse
—
MI
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/10/2006
Last updated
05/07/2018
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