Provider Demographics
NPI:1013920438
Name:HOEKSEMA, JAMES HENRY (PSYD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HENRY
Last Name:HOEKSEMA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E 8TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3079
Mailing Address - Country:US
Mailing Address - Phone:616-355-0473
Mailing Address - Fax:616-355-0480
Practice Address - Street 1:720 E 8TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3079
Practice Address - Country:US
Practice Address - Phone:616-355-0473
Practice Address - Fax:616-355-0480
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006620103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0G01164Medicare UPIN