OrganizationActive
Adolescent and Family Behavioral Health Services
NPI 1184054652 · Psychologist · Grand Rapids, MI
Provider details
- NPI number
- 1184054652
- Entity type
- Organization
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Authorized official
- Valencia Agnew, Psychologist
- License
- 6301015520 (MI)
Practice location
3501 Lake Eastbrook Blvd Se
#258
Grand Rapids, MI 49546-5938
Phone: (616) 719-0194
Fax: (800) 219-5205
Mailing address
2566 Woodmeadow Dr Se
Grand Rapids, MI 49546-8031
Registry dates
- Enumerated
- 2013-11-20
- Last updated
- 2019-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.