Provider Demographics
NPI:1225668684
Name:EXPRESSIVE EXPLORATIONS
Entity Type:Organization
Organization Name:EXPRESSIVE EXPLORATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNALISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMERLUND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-259-5136
Mailing Address - Street 1:3232 WOODWARD AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-3038
Mailing Address - Country:US
Mailing Address - Phone:616-259-5136
Mailing Address - Fax:
Practice Address - Street 1:1845 RW BERENDS DR SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-4955
Practice Address - Country:US
Practice Address - Phone:616-259-5136
Practice Address - Fax:616-345-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty