ARDEAN BETH BROCK-VANDERWALL M.DIV., M.A. NPI 1013147495

Counselor (Professional) in Grand Rapids, MI

NPI 1013147495 Individual Female Counselor Professional

About ARDEAN BROCK-VANDERWALL

Ardean Brock-vanderwall is a provider established in Grand Rapids, Michigan and her medical specialization is counselor (professional) . The NPI number of Ardean Brock-vanderwall is 1013147495 and was assigned on July 2009. The practitioner's primary taxonomy code is 101YP2500X with license number 6401011131 (MI). The provider is registered as an individual and her NPI record was last updated 6 years ago.

Ardean Brock-vanderwall is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1013147495

Provider Name ARDEAN BETH BROCK-VANDERWALL M.DIV., M.A.
Provider Location Address2828 KRAFT AVE. GRAND RAPIDS, MI 49512
Provider Mailing Address3208 WOODBERRY DRIVE GRAND RAPIDS, MI 49512
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-20-2009
Last Update Date10-26-2015


Primary Taxonomy

Taxonomy Code101YP2500X
ClassificationCounselor
TypeBehavioral Health & Social Service Providers
SpecializationProfessional
License No.6401011131
License StateMI

Business Address

ARDEAN BETH BROCK-VANDERWALL M.DIV., M.A.
2828 KRAFT AVE.
GRAND RAPIDS, MI
ZIP 49512
Phone: (616) 949-9550
Fax: (616) 949-9551

Get Directions


Mailing Address

ARDEAN BETH BROCK-VANDERWALL M.DIV., M.A.
3208 WOODBERRY DRIVE
GRAND RAPIDS, MI
ZIP 49512
Phone: (616) 893-6420
Fax: (616) 891-9676



NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.