Provider Demographics
NPI:1821743477
Name:MEGAN TROMBKA, LMSW, PLLC
Entity Type:Organization
Organization Name:MEGAN TROMBKA, LMSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT AGENT
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TROMBKA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-402-5818
Mailing Address - Street 1:2215 NEW TOWN DR NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-3917
Mailing Address - Country:US
Mailing Address - Phone:517-402-5818
Mailing Address - Fax:
Practice Address - Street 1:3280 E BELTLINE CT NE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9494
Practice Address - Country:US
Practice Address - Phone:517-402-5818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty