Organization
GRAND RAPIDS CENTER FOR PSYCHOTHERAPY PLLC
Active
Other names
Carolyn H. Carino LMSW ACSW SPADA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN H CARINO LMSW ACSW SPADA (OWNER/PRESIDENT)
(616) 949-6262
Entity
Organization
Contact information
Practice address
4519 CASCADE RD SE, SUITE 3, GRAND RAPIDS, MI 49546-3666
(616) 949-6262
(616) 425-2003
Mailing address
4519 CASCADE RD SE, SUITE 3, GRAND RAPIDS, MI 49546-3666
(616) 949-6262
(616) 425-2003
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
680103034469
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801034469
STATE OF MICHIGAN DEPARTMENT OF COMMUNITY HEALTH LICENSE
MI
01
—
881817049
NATIONAL ASSOCIATION OF SOCIAL WORKERS ACADEMY OF CERTIFIED SOCIAL WORKERS
—
Enumeration date
04/08/2010
Last updated
04/14/2011
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