Organization
ROBERT W VAN NOORD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WILLIAM VAN NOORD PH.D. (LICENSED PSYCHOLOGIST/PRESIDENT)
(616) 956-6700
Entity
Organization
Contact information
Practice address
4133 EMBASSY DR SE, GRAND RAPIDS, MI 49546-2418
(616) 956-6700
(616) 956-6773
Mailing address
4133 EMBASSY DR SE, GRAND RAPIDS, MI 49546-2418
(616) 956-6700
(616) 956-6773
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
6301001896
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301001896
FPSYCHOLOGIST LICENSE #
MI
01
—
OD14556
BLUE CROSS BLUE SHIELD PIN
MI
Enumeration date
12/28/2010
Last updated
12/28/2010
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