Provider Demographics
NPI:1023179306
Name:TRIBE, AMY MICHELLE (MSW, CAADC)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:MICHELLE
Last Name:TRIBE
Suffix:
Gender:F
Credentials:MSW, CAADC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MICHELLE
Other - Last Name:WESCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, CAADC
Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 LINDEN ST STE 1
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-1880
Practice Address - Country:US
Practice Address - Phone:231-796-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010841971041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI38 2831313OtherTOUCHSTONE EIC NUMBER
MI38 2831313OtherTOUCHSTONE EIC NUMBER