Basic Information
| Provider Information | |||||||||
| NPI: | 1386773455 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOSIER | ||||||||
| FirstName: | SYLVA | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | LPC, LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1007 KENDALWOOD ST NE | ||||||||
| Address2: | |||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495053231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6163647889 | ||||||||
| FaxNumber: | 6163647889 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E BELTLINE AVE NE | ||||||||
| Address2: | |||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495255848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164566135 | ||||||||
| FaxNumber: | 6167719779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 6401003196 | MI | X | Behavioral Health & Social Service Providers | Counselor | 1041C0700X | 6801058604 | MI | X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.