Individual provider · Type 1 NPI

Tasha Bourne, LMSW

Clinical Social Worker · Grandville, MI

NPI number 1164780888 Active

Practice location

6105 Wilson Ave SW Ste 204
Grandville, MI 49418-9714

Mailing address

100 Michigan St NE # MC845
Grand Rapids, MI 49503-2560

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Clinical Social Worker Primary 1041C0700X6801094573 (MI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1164780888

Tasha Bourne, LMSW's National Provider Identifier is 1164780888, issued on May 1, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Grandville, MI. The record was last updated on Jan 7, 2019.