Organization
CHERRY STREET SERVICES, INC.
Active
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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