Provider Demographics
NPI:1619191921
Name:HUVER, KERRY LINN (MPS)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:LINN
Last Name:HUVER
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 RICHARDS DRIVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4736
Mailing Address - Country:US
Mailing Address - Phone:616-446-9108
Mailing Address - Fax:
Practice Address - Street 1:500 CASCADE WEST PKWY SE STE 240
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-591-9000
Practice Address - Fax:616-591-9060
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802079981104100000X
MI221700000X
MI6401013678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist