Provider Demographics
NPI:1144752346
Name:DAYBREAK PSYCHOTHERAPY
Entity Type:Organization
Organization Name:DAYBREAK PSYCHOTHERAPY
Other - Org Name:DAYBREAK MENTAL WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-879-9965
Mailing Address - Street 1:3124 N WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8121
Mailing Address - Country:US
Mailing Address - Phone:616-879-9965
Mailing Address - Fax:888-408-3103
Practice Address - Street 1:3124 N WELLNESS DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8121
Practice Address - Country:US
Practice Address - Phone:616-879-9965
Practice Address - Fax:888-408-3103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014390251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health