Individual provider · Type 1 NPI

Jenna Stack, LMSW

Clinical Social Worker · Grandville, MI

NPI number 1922451293 Active

Practice location

4211 Parkway Place Dr SW
Grandville, MI 49418-2695

Call (616) 222-3700 Map

Fax (616) 222-3707

Mailing address

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

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X6801105833 (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 1922451293

Jenna Stack, LMSW's National Provider Identifier is 1922451293, issued on Jul 21, 2016. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Grandville, MI. The record was last updated on Nov 25, 2025.