Provider Demographics
NPI:1952433526
Name:SPIEKER, STEPHEN (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SPIEKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 GRAND WOODS CT NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-2138
Mailing Address - Country:US
Mailing Address - Phone:616-361-8368
Mailing Address - Fax:
Practice Address - Street 1:2340 DEAN LAKE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-4446
Practice Address - Country:US
Practice Address - Phone:616-791-8584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401001519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional