Provider Demographics
NPI:1841855178
Name:BLAUER, NATALIE J (LMSW)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:J
Last Name:BLAUER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:J
Other - Last Name:SERNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1248 DIVOT DR NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-2470
Mailing Address - Country:US
Mailing Address - Phone:616-644-2835
Mailing Address - Fax:
Practice Address - Street 1:800 MONROE AVE NW STE 206
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1448
Practice Address - Country:US
Practice Address - Phone:616-644-2835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801107876104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker