Basic Information
| Provider Information | |||||||||
| NPI: | 1912217365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIKE-BELD | ||||||||
| FirstName: | KRISTINA | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2132 WRENWOOD STREET SW | ||||||||
| Address2: | |||||||||
| City: | WYOMING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164512021 | ||||||||
| FaxNumber: | 6164518936 | ||||||||
| Practice Location | |||||||||
| Address1: | 2855 44TH ST SW STE 175 | ||||||||
| Address2: | |||||||||
| City: | GRANDVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494182083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6168289574 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2010 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801088638 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.