Provider Demographics
NPI:1376820860
Name:THETHIRDCHAIR
Entity Type:Organization
Organization Name:THETHIRDCHAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-916-3711
Mailing Address - Street 1:648 MONROE AVE NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1452
Mailing Address - Country:US
Mailing Address - Phone:616-916-3711
Mailing Address - Fax:616-825-6015
Practice Address - Street 1:648 MONROE AVE NW
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1452
Practice Address - Country:US
Practice Address - Phone:616-916-3711
Practice Address - Fax:616-825-6015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty