Provider Demographics
NPI:1962723999
Name:STERK, KRISTYN MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:MARIE
Last Name:STERK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:MARIE
Other - Last Name:LEHOCKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:745 LAKE MICHIGAN DR NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-5617
Mailing Address - Country:US
Mailing Address - Phone:616-403-9753
Mailing Address - Fax:
Practice Address - Street 1:745 LAKE MICHIGAN DR NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-5617
Practice Address - Country:US
Practice Address - Phone:616-403-9753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010920921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical