Provider Demographics
NPI:1003160854
Name:GERMINDER, MICHELLE (BS,RSST,RAC,IMH-E(R))
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:GERMINDER
Suffix:
Gender:F
Credentials:BS,RSST,RAC,IMH-E(R)
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS
Mailing Address - Street 1:500 BARFIELD DR.
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-9018
Mailing Address - Country:US
Mailing Address - Phone:269-948-8041
Mailing Address - Fax:269-948-9319
Practice Address - Street 1:500 BARFIELD DR.
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-9018
Practice Address - Country:US
Practice Address - Phone:269-948-8041
Practice Address - Fax:269-948-9319
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 171M00000X
MI6803086455104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker