Provider Demographics
NPI:1396081253
Name:WILLIAM C PADDING, LMSW, ACSW, PC
Entity type:Organization
Organization Name:WILLIAM C PADDING, LMSW, ACSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:PADDING
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-785-8900
Mailing Address - Street 1:640 3 MILE RD NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544-8209
Mailing Address - Country:US
Mailing Address - Phone:616-785-8900
Mailing Address - Fax:616-785-8900
Practice Address - Street 1:640 3 MILE RD NW
Practice Address - Street 2:SUITE 101
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-8209
Practice Address - Country:US
Practice Address - Phone:616-785-8900
Practice Address - Fax:616-785-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010632661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty