Provider Demographics
NPI:1225453103
Name:WOHLFERT, MICHELLE MARIE I (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:WOHLFERT
Suffix:I
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 SIERRA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-2255
Mailing Address - Country:US
Mailing Address - Phone:616-443-9124
Mailing Address - Fax:
Practice Address - Street 1:72 SHELDON BLVD SE
Practice Address - Street 2:THE SALVATION ARMY TURNING POINT PROGRAM
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4234
Practice Address - Country:US
Practice Address - Phone:616-742-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010795081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical