Basic Information
| Provider Information | |||||||||
| NPI: | 1801223870 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPKE | ||||||||
| FirstName: | MINDY | ||||||||
| MiddleName: | LYNN-FOSTER | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FOSTER | ||||||||
| OtherFirstName: | MINDY | ||||||||
| OtherMiddleName: | LYNN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1876 SUN PARK CT | ||||||||
| Address2: | |||||||||
| City: | ZEELAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494648335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6167726973 | ||||||||
| FaxNumber: | 6167726973 | ||||||||
| Practice Location | |||||||||
| Address1: | 3250 36TH ST SE | ||||||||
| Address2: | |||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495128193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6169427294 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2013 | ||||||||
| LastUpdateDate: | 02/27/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TF0000X | 6301011491 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Family |
No ID Information.