Provider Demographics
NPI:1891215166
Name:HORAK FAMILY AND PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:HORAK FAMILY AND PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:HORAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-942-2327
Mailing Address - Street 1:801 BROADWAY AVE NW APT 443
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-4467
Mailing Address - Country:US
Mailing Address - Phone:616-942-2327
Mailing Address - Fax:
Practice Address - Street 1:801 BROADWAY AVE NW APT 443
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-4467
Practice Address - Country:US
Practice Address - Phone:616-942-2327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty