Provider Demographics
NPI:1437332871
Name:MCDOWELL FORREST, JEANETTE (LLP)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:
Last Name:MCDOWELL FORREST
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:GERTRUDE
Other - Middle Name:JEANETTE
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:233 E FULTON ST
Mailing Address - Street 2:SUITE 114-C
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-3200
Mailing Address - Country:US
Mailing Address - Phone:616-776-3923
Mailing Address - Fax:616-776-3024
Practice Address - Street 1:233 FULTON ST E STE 104
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3261
Practice Address - Country:US
Practice Address - Phone:616-776-3923
Practice Address - Fax:616-776-3024
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009848103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling