Provider Demographics
NPI:1740387539
Name:FROMMEYER, PETER THOMAS (MSW)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:THOMAS
Last Name:FROMMEYER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PARCHMENT DR. SE
Mailing Address - Street 2:PSYCHOLOGY ASSOCIATES OF GRAND RAPIDS, PC
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:616-957-9112
Mailing Address - Fax:616-957-2409
Practice Address - Street 1:1000 PARCHMENT DR SE
Practice Address - Street 2:PSYCHOLOGY ASSOCIATES OF GRAND RAPIDS, PC
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-957-9112
Practice Address - Fax:616-957-2409
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010867471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical