Organization · Type 2 NPI

Pine Rest Christian Mental Health Services

Addiction Medicine (Internal Medicine) Physician · Grand Rapids, MI

NPI number 1679777049 Active

Practice location

243 68th St SE
Grand Rapids, MI 49548-6924

Mailing address

300 68th St SE
Grand Rapids, MI 49548-6927

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Mental Health Counselor 101YM0800XNone listed
Professional Counselor 101YP2500XNone listed
Behavior Analyst 103K00000XNone listed
Psychologist 103T00000XNone listed
Social Worker 104100000XNone listed
Internal Medicine Physician 207R00000XNone listed
Addiction Medicine (Internal Medicine) Physician Primary 207RA0401XNone listed
Occupational Therapist 225X00000XNone listed
Speech-Language Pathologist 235Z00000XNone listed
Substance Abuse Rehabilitation Facility 324500000X410334 (MI)
Physician Assistant 363A00000XNone listed
Nurse Practitioner 363L00000XNone listed

Addiction Medicine (Internal Medicine) Physician: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

2 other providers at this address

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About NPI 1679777049

Pine Rest Christian Mental Health Services's National Provider Identifier is 1679777049, issued on Jun 12, 2007. The primary taxonomy on file is Addiction Medicine (Internal Medicine) Physician (207RA0401X), and the practice location is in Grand Rapids, MI. The record was last updated on Jun 18, 2026.