Provider Demographics
NPI:1801387691
Name:WESTMAAS, CHAD ROBERT (LPC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:ROBERT
Last Name:WESTMAAS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 BROOK DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-2811
Mailing Address - Country:US
Mailing Address - Phone:616-633-4889
Mailing Address - Fax:
Practice Address - Street 1:6100 NEWPORT RD STE 2222
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-9235
Practice Address - Country:US
Practice Address - Phone:269-488-5929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016670101YM0800X
MI6401019275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health