Provider Demographics
NPI:1720784648
Name:GREG WEICHHAND LLC
Entity Type:Organization
Organization Name:GREG WEICHHAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEICHHAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LLP CAADC
Authorized Official - Phone:616-915-8400
Mailing Address - Street 1:54 OSWEGO ST NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-6046
Mailing Address - Country:US
Mailing Address - Phone:616-915-8400
Mailing Address - Fax:
Practice Address - Street 1:2716 EAST PARIS AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6139
Practice Address - Country:US
Practice Address - Phone:616-975-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty