ETHAN PEMBERTON
NPI 1306486204
Social Worker - Clinical in Grand Rapids, MI
About Ethan Pemberton NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN PEMBERTON (NPI 1306486204) is an individual clinical provider in Grand Rapids, Michigan and active in the NPI registry since January 2020.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ethan Pemberton's NPI number?
The NPI number for Ethan Pemberton is 1306486204. It was assigned to this individual provider in the NPPES registry on January 9, 2020.
Where is Ethan Pemberton located?
Ethan Pemberton practices at 206 Fuller Ave SE, Grand Rapids, MI 49506. The listed phone number is (810) 347-2159.
What is Ethan Pemberton's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
When was this NPI record last updated?
The NPPES record for Ethan Pemberton was last updated on June 12, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.