1114334562 NPI number — BETHANY ANNE SWITTER CRAMER MA, LLPC

Table of content: BETHANY ANNE SWITTER CRAMER MA, LLPC (NPI 1114334562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114334562 NPI number — BETHANY ANNE SWITTER CRAMER MA, LLPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRAMER
Provider First Name:
BETHANY
Provider Middle Name:
ANNE SWITTER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LLPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRAMER
Provider Other First Name:
BETHANY
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1114334562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 533
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND HAVEN
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49417-0533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-414-7598
Provider Business Mailing Address Fax Number:
888-408-3103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
GRAND HAVEN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49417-1390
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-414-7598
Provider Business Practice Location Address Fax Number:
888-408-3103
Provider Enumeration Date:
07/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  6401014390 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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