Organization
CLAYSTONE CLINICAL ASSOCIATES PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SUE BOCK (OFFICE MANAGER)
(616) 949-7460
Entity
Organization
Contact information
Practice address
2401 CAMELOT CT SE STE E, GRAND RAPIDS, MI 49546-6083
(616) 949-7460
(616) 949-3018
Mailing address
2401 CAMELOT CT SE STE E, GRAND RAPIDS, MI 49546-6083
(616) 949-7460
(616) 949-3018
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/12/2006
Last updated
07/29/2024
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