Provider Demographics
NPI:1093472193
Name:CLINK, TROY J (LMSW)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:J
Last Name:CLINK
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8596 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-9566
Mailing Address - Country:US
Mailing Address - Phone:616-706-8568
Mailing Address - Fax:
Practice Address - Street 1:8596 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:JENISON
Practice Address - State:MI
Practice Address - Zip Code:49428-9566
Practice Address - Country:US
Practice Address - Phone:616-706-8568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010809801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical