Provider Demographics
NPI:1346091873
Name:HOLLEBEEK, DIRK (MAC, MED)
Entity Type:Individual
Prefix:
First Name:DIRK
Middle Name:
Last Name:HOLLEBEEK
Suffix:
Gender:M
Credentials:MAC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E 24TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4973
Mailing Address - Country:US
Mailing Address - Phone:616-209-9023
Mailing Address - Fax:
Practice Address - Street 1:217 E 24TH ST STE 201
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4973
Practice Address - Country:US
Practice Address - Phone:616-209-9023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health