Provider Demographics
NPI:1407872526
Name:HILBER, CHARLOTTE JEAN (MA LMFT)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:JEAN
Last Name:HILBER
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-1600
Mailing Address - Country:US
Mailing Address - Phone:616-780-1889
Mailing Address - Fax:
Practice Address - Street 1:707 E BELTLINE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-6045
Practice Address - Country:US
Practice Address - Phone:616-780-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5112-042687106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist